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  4. /NDC 00048-1070-05

NDC 00048-1070-05

levothyroxine 100 mcg Tab at Glendale Adventist Medical Center

Glendale, CA

Pricing by billing methodology

Price type

All methodologies

$7

431–440 samples

Aggregated across all available billing methodologies for this code.

Case rate

$7

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

$13

Reflects negotiated fee schedule rates with commercial payers.

Per diem

Not reported

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$7

431–440 samples

Reflects a negotiated percentage of total billed charges.

Other

$12

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Jul 30, 2026

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