NDC 65628-0050-04
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
LIDOCAINE-DIPHENHYD-AL-MAG-SIM MWSH 25-200-400-40 MG/30ML5 ML
Livingston, TX
See all hospitals reporting NDC 65628-0050-04 →Price type
Memorial Hospital Of Polk County’s median price of $62 is 19% below the median hospital's median price ($76), higher than 43% of the 189 hospitals reporting NDC 65628-0050-04. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Last updated: Feb 28, 2026
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