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NDC 72266012705

72266-0127-05 - dicyclomine 10 mg/mL Soln

Reported by 25 hospitals in the network under the other methodology.

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.

Reflects a payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$4

Average

$165

Median

$86

High

$730

Hospitals reporting this code

#HospitalLocation
1Bluffton Health System LLCBluffton, IN$37$40$40$138—
2Wesley Health System LLCHattiesburg, MS$11$444$387$592$193
3Naples HMA LLCNaples, FL$18$98$90$98$22
4Naples HMA LLCFL 34114, FL$18$98$86$98$23
5Vicksburg Healthcare LLCVicksburg, MS$70$696$571$1.1k$374
6Naples HMA LLCNaples, FL$18$98$90$98$22
7Northwest Sahurita Hospital LLCAZ 85748, AZ$7$12$13$55$2
8Victoria of Texas LPVictoria, TX$24$68$112$382$102
9Victoria of Texas LPVictoria, TX$24$68$112$382$102
10Northwest Sahurita Hospital LLCAZ 85629, AZ$7$12$13$55$2
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