NDC 39822-4200-02
Lodi, CA
Price type
All methodologies
$188
174–201 samples
Case rate
Not reported
Fee schedule
$310
Per diem
Not reported
Percent of billed charges
$125
174–201 samples
Other
Not reported
Last updated: Aug 2, 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.