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NDC 9999910633

MOXIFLOXACIN INTRACAMERAL 150 MCG/0.1 ML OPTHALMIC SOLUTION

Reported by 20 hospitals in the network under the percent of billed charges 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 negotiated percentage of total billed charges.

National pricing summary

Low

$139

Average

$182

Median

$183

High

$240

Hospitals reporting this code

#HospitalLocationApproximate 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.
1Catholic Health Initiatives ColoradoColorado Springs, CO$143$156$61—$71$264
2Catholic Health Initiatives ColoradoSalt Lake City, UT$163$185$54—$107$300
3Catholic Health Initiatives ColoradoColorado Springs, CO$150$173$60—$81$264
4Catholic Health Initiatives ColoradoLehi, UT$162$184$54—$107$300
5St Francis HospitalColorado Springs, CO$137$146$54—$71$255
6Longmont United HospitalLongmont, CO$120$147$64—$71$270
7Catholic Health Initiatives ColoradoFrisco, CO$180$198$64—$81$276
8Commonspirit Kansas, Inc.Ulysses, KS$250$210$80—$96$285
9Commonspirit Kansas, Inc.Dodge City, KS$240$230$42—$105$270
10Catholic Health Initiatives ColoradoPueblo, CO$174$176$61—$83$264
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Look up this code directly

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