NDC 54162-0011-01
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
dibucaine 1 Ointment 30 gm
Reported by 6 hospitals in the network under the case rate methodology.
Low
$6
Average
$699
Median
$15
High
$3.7k
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Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
Showing only prices reported under the case rate methodology. Choose another in the filter above to change the chart. 6 hospitals; the 90th percentile is 375.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Northwest Sahurita Hospital LLC Tucson, AZ | $6 | $6 | — | — | — | $1 – $6 |
| 2 | Northwest Sahurita Hospital LLC Sahuarita, AZ | $6 | $6 | — | — | — | $1 – $6 |
| 3 | Northwest Hospital LLC Tucson, AZ | $6 | $6 | — | — | — | $1 – $6 |
| 4 | UPMC Northwest Seneca, PA | $3.7k | $3.7k | — | — | — | $2 – $3.7k |
| 5 | OU Health - University of Oklahoma Medical Center Oklahoma City, OK | $448 | $448 | — | — | — | $448 – $448 |
| 6 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $24 | $24 | — | — | — | $4 – $24 |
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