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NDC 9999910285

LEVOTHYROXINE 25 MCG/ML ORAL SUSPENSION - COMPOUND

Reported by 20 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

$86

Average

$112

Median

$113

High

$149

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$44$89$96$163$38
2Catholic Health Initiatives ColoradoSalt Lake City, UT$66$101$114$186$34
3Catholic Health Initiatives ColoradoColorado Springs, CO$50$93$107$163$37
4Catholic Health Initiatives ColoradoLehi, UT$66$100$114$186$34
5St Francis HospitalColorado Springs, CO$44$85$90$158$34
6Longmont United HospitalLongmont, CO$44$74$91$167$40
7Catholic Health Initiatives ColoradoFrisco, CO$50$111$122$171$39
8Commonspirit Kansas, Inc.Ulysses, KS$59$155$130$176$49
9Commonspirit Kansas, Inc.Dodge City, KS$65$149$143$167$26
10Catholic Health Initiatives ColoradoPueblo, CO$51$108$109$163$38
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