NDC 17156002630

technetium Tc-99m tetrofosmin Kit 33 millicurie at St Josephs Community Hospital of West Bend Inc

West Bend, WI

Pricing by billing methodology

Price type

All methodologies

$339

12–120 samples

Case rate

Not reported

Fee schedule

Not reported

Per diem

Not reported

Percent of billed charges

$339

6–60 samples

Other

$332

6–60 samples

Last updated: Dec 31, 2025

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