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NDC 9999910664

DIPHENHYD 25 MG-LIDO 200 MG-MAG,AL 400 MG-SIMETH 40 MG/30 ML MOUTHWASH

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

Based on 176–410 billing samples across every hospital reporting.

Low

$3

Average

$6

Median

$5

High

$11

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.
1Commonspirit Kansas, Inc.Garden City, KS$6$11$18150$2$6
2Catholic Health Initiatives ColoradoFrisco, CO$4$6$88–80$2$6
3Catholic Health Initiatives ColoradoColorado Springs, CO$3$5$76–60$2$6
4Commonspirit Kansas, Inc.Dodge City, KS$5$11$214–40$2$6
5Longmont United HospitalLongmont, CO$3$4$62–20$2$6
6Commonspirit Kansas, Inc.Ulysses, KS$5$6$112–20$2$6
7Catholic Health Initiatives ColoradoPueblo, CO$4$6$92–20$2$6
8Catholic Health Iniatives ColoradoWestminster, CO$3$4$52–20$2$6
9Catholic Health Initiatives ColoradoSalt Lake City, UT$4$4$1—$2$7
10Catholic Health Initiatives ColoradoColorado Springs, CO$3$9$29—$2$6
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Look up this code directly

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