NDC 00904-6422-81
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Generation details were not recorded for this description.
Original text from hospital filings
POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET
Council Bluffs, IA
See all hospitals reporting NDC 00904-6422-81 →Price type
Alegent Health Bergan Mercy Health System’s median price of $152 is 1641% above the median hospital's median price ($9), higher than 83% of the 71 hospitals reporting NDC 00904-6422-81. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Last updated: Feb 28, 2026
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