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NDC 7138451108

MOXIFLOXACIN (PF) 4 MG/0.8 ML IN SODIUM CHLOR,ISO-OSM INTRAOCULAR SOLN

Reported by 20 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

$128

Average

$168

Median

$169

High

$222

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$65$133$144$244$57
2Catholic Health Initiatives ColoradoSalt Lake City, UT$99$150$171$278$50
3Catholic Health Initiatives ColoradoColorado Springs, CO$75$139$160$244$56
4Catholic Health Initiatives ColoradoLehi, UT$99$150$170$278$50
5St Francis HospitalColorado Springs, CO$65$126$135$236$50
6Longmont United HospitalLongmont, CO$65$111$136$250$59
7Catholic Health Initiatives ColoradoFrisco, CO$75$167$183$255$59
8Commonspirit Kansas, Inc.Ulysses, KS$89$231$194$264$74
9Commonspirit Kansas, Inc.Dodge City, KS$97$222$213$250$39
10Catholic Health Initiatives ColoradoPueblo, CO$77$161$163$244$56
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