NDC 39822-4200-02
Glendale, CA
Price type
All methodologies
$168
3–30 samples
Case rate
$162
Fee schedule
$320
Per diem
Not reported
Percent of billed charges
$161
3–30 samples
Other
$301
Last updated: Jul 30, 2026
See COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.