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NDC 42571-0141-26

DORZOLAMIDE 2 % OPHT DROP

Reported by 33 hospitals in the network under the percent of billed charges 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 negotiated percentage of total billed charges.

National pricing summary

Low

$7

Average

$140

Median

$105

High

$444

Hospitals reporting this code

#HospitalLocation
1Northwestern Medicine Central DuPage HospitalWinfield, IL$109$420$444$762$192
2Northwestern Memorial HospitalChicago, IL$37$222$298$762$201
3Northwestern Medicine Kishwaukee HospitalDeKalb, IL$94$346$356$513$104
4Northwestern Medicine Valley West HospitalSandwich, IL$108$372$353$571$132
5Northern Illinois Medical Center DBA Northwestern Medicine McHenry HospitalMcHenry, IL$41$101$105$213$47
6Northwestern Medicine Delnor HospitalGeneva, IL$58$223$214$355$79
7Palos Community HospitalPalos Heights, IL$26$111$118$186$55
8Northwestern Medicine Marianjoy Rehabilitation HospitalWheaton, IL$193$276$296$460$82
9Portland Adventist Medical CenterPortland, OR$0$69$67$251$19
10Johnson Memorial HospitalStafford Springs, CT$3$12$11$12$2
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