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NDC 74300001067

74300-0010-67 - glycerin/hypromellose/peg 400 Soln

Reported by 43 hospitals in the network.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

National pricing summary

Low

$4

Average

$664.5k

Median

$8

High

$28571.5k

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$6$20$23$53$13
2Lutheran Musculoskeletal Center LLCFort Wayne, IN$3$11$13$34$7
3St. Joseph Health System, LLCIN 46802, IN$9$34$28571.5k$90$166598.6k
4Durant HMA LLCDurant, OK$4$24$20$29$8
5Wesley Health System LLCHattiesburg, MS$5$19$22$46$12
6Naples HMA LLCFL 34114, FL$3$9$9$16$5
7Cocke County HMA, LLCNewport, TN$2$4$5$9$2
8Metro Knoxville HMA LLCKnoxville, TN$2$4$4$6$2
9Metro Knoxville HMA LLCPowell, TN$2$4$5$9$2
10Affinity Hospital LLCBirmingham, AL$5$19$18$32$7
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