NDC 63323-0488-17
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
LIDO 1.5% W/EPI PF 1:200K 1OML
Low
$21
Average
$4.8k
Median
$5.3k
High
$8.5k
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Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | UPMC Northwest Seneca, PA | $3.7k | $3.7k | — | — | — | $3 – $3.7k |
| 2 | Baylor University Medical Center Dallas, TX | $6.9k | $6.9k | $556 | 8% | — | $21 – $7.4k |
| 3 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL | $8.5k | $8.5k | — | — | — | $31 – $8.5k |
| 4 | Methodist Lebonheur Germantown Hosp GERMANTOWN, TN | $21 | $21 | — | — | — | $5 – $21 |
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