NDC 65143105
Polyethylene Glycol-Propylene Glycol Ophth Soln 0.4-0.3% at Sanford Mayville Medical Center
Mayville, ND
Reported pricing
Low
$6
Average
$17
Median
$19
High
$21
Aggregated across all available billing methodologies for this code.
Last updated: Mar 4, 2026
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