NDC 64950-0362-04
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
64950-0362-04 - cocaine nasal 4 Soln
Reported by 33 hospitals in the network under the other methodology.
Based on 3–30 billing samples across every hospital reporting.
Low
$0
Average
$338
Median
$23
High
$1.9k
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 33 hospitals; the 90th percentile is 83448.4× 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 | Location | Approximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | Fairview Health Services | Minneapolis, MN | $111 | $111 | — | 2–20 | $1 | $111 |
| 2 | Bexar County Hospital District | San Antonio, TX | $206 | $206 | — | 1–10 | $206 | $3.4k |
| 3 | Bluffton Health System LLC | Bluffton, IN | $600 | $600 | $136 | — | $428 | $2.5k |
| 4 | Dukes Health System LLC | Peru, IN | $1.5k | $1.5k | $266 | — | $871 | $4.8k |
| 5 | St. Joseph Health System, LLC | Wayne, IN | $1.9k | $1.9k | $20 | — | $449 | $1.9k |
| 6 | Oro Valley Hospital LLC | Tucson, AZ | $2 | $2 | $1 | — | $1 | $9 |
| 7 | Metro Knoxville HMA LLC | Knoxville, TN | $2 | $2 | — | — | $1 | $3 |
| 8 | Poplar Bluff Regional Medical Center LLC | Poplar Bluff, MO | $1.8k | $1.8k | — | — | $563 | $2.5k |
| 9 | Piney Woods Healthcare System LP | Lufkin, TX | $2 | $2 | — | — | $1 | $14 |
| 10 | La Porte Hospital Company LLC | La Porte, IN | $684 | $684 | — | — | $684 | $2.4k |
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