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NDC 1747871110

LIDOCAINE HCL 2 % MUCOSAL JELLY

Reported by 14 hospitals in the network under the other methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

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

National pricing summary

Low

$16

Average

$65

Median

$41

High

$180

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$7$31$31$26—
2Catholic Health Initiatives ColoradoColorado Springs, CO$8$180$180$26—
3St Francis HospitalColorado Springs, CO$7$180$180$25—
4Longmont United HospitalLongmont, CO$7$33$33$27—
5Catholic Health Initiatives ColoradoFrisco, CO$8$24$37$27$18
6Commonspirit Kansas, Inc.Ulysses, KS$24$77$77$28—
7Commonspirit Kansas, Inc.Dodge City, KS$10$77$77$27—
8Catholic Health Initiatives ColoradoPueblo, CO$8$44$44$26—
9Catholic Health Initiatives ColoradoFort Morgan, CO$9$70$70$29—
10Catholic Health Initiatives ColoradoDurango, CO$9$5$16$27$19
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