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  4. /NDC 51991090601

NDC 51991090601

TETRACYCLINE HCL 250 MG PO CAPS at The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania

Philadelphia, PA

Pricing by billing methodology

Price type

All methodologies

$16

Aggregated across all available billing methodologies for this code.

Case rate

$24

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

Fee schedule

$24

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

$14

Reflects a negotiated percentage of total billed charges.

Other

$24

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

Last updated: Feb 10, 2026

Compare to other hospitals

See TETRACYCLINE HCL 250 MG PO CAPS pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.

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