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NDC 55741040202

55741-0402-02 - dibucaine topical 1 Ointment

Reported by 34 hospitals in the network.

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.

National pricing summary

Low

$5

Average

$840.3k

Median

$7

High

$28571.5k

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$13$26$29$49$11
2Lutheran Musculoskeletal Center LLCFort Wayne, IN$8$15$17$31$6
3St. Joseph Health System, LLCIN 46802, IN$20$50$28571.5k$84$166598.6k
4Vicksburg Healthcare LLCVicksburg, MS$32$95$101$233$61
5Triad of Alabama LLCAL 36305, AL$4$22$19$29$7
6Baylor Scott & White Medical Center - TempleTemple, TX$2$7$7$11$2
7Baylor Scott & White Medical Center - BrenhamBrenham, TX$1$6$5$11$3
8Baylor Scott & White Medical Center - TaylorTaylor, TX$2$6$6$10$2
9Baylor Scott & White Medical Center - HillcrestWaco, TX$1$7$7$10$2
10Baylor Scott & White All Saints Medical Center - Fort WorthFort Worth, TX$2$7$7$10$2
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