NYSTATIN 100,000 UNIT/GM CREAM
NYSTATIN 100,000 UNIT/GM CREAM, a generic antifungal medication, has a Medicare acquisition cost of $0.22 per gram, though hospital charges often exceed acquisition costs by significant multiples.
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
Nystatin cream treats fungal skin infections like candidiasis and is commonly prescribed for topical antifungal therapy. This generic medication typically has consistent Medicare reimbursement rates across different pharmacy providers, making billing reconciliation relatively predictable.
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Common billing errors — Anti-infectives (Antifungal/Antiviral) charges
Hospital bills for anti-infective medications frequently contain charges above the benchmark, with markups ranging from 300% to 1,200% above the average NADAC acquisition cost of $0.57 for this drug class. Common billing issues include duplicate charges for the same antifungal or antiviral medication administered during overlapping time periods, particularly when patients transition between different administration routes or dosing schedules. Generic substitution discrepancies create potential differences when hospitals bill for brand-name antifungals like Diflucan while dispensing generic fluconazole, yet patients see charges reflecting the higher-cost branded version. Bundling errors occur when anti-infective drugs administered as part of surgical prophylaxis appear as separate line items despite being included in procedure codes. Patients should verify that IV-to-oral conversions are properly documented, as hospitals sometimes continue billing for expensive intravenous formulations after switching to oral versions of the same medication.
What to check on your bill
When reviewing anti-infective drug charges on your hospital bill, examine the medication name, dosage, and administration frequency listed on each line item. Cross-reference generic versus brand name pricing, as charges above the benchmark often occur when brand names are billed instead of generic equivalents like fluconazole versus Diflucan. Verify the quantity matches your actual treatment duration, particularly for IV medications that may be billed per dose or per day. Look for duplicate entries or overlapping antifungal and antiviral treatments that weren't medically necessary simultaneously. Check if oral medications were switched to IV formulations without clear documentation, as IV administration typically carries significantly higher charges. Review pharmacy line items for preparation fees, compounding charges, or waste fees that may not apply to standard anti-infective medications. Compare the per-unit cost against published drug pricing databases to identify potential differences. Document any discrepancies between the prescribed medication on your discharge papers and what appears on the billing statement, as medication reconciliation errors frequently result in incorrect charges above established benchmarks.
FAQ — Anti-infectives (Antifungal/Antiviral) billing
What is the average acquisition cost for anti-infective antifungal and antiviral drugs?
How many drugs are typically included in the anti-infective antifungal/antiviral class for billing analysis?
How should billing departments handle charges above the benchmark for antifungal and antiviral medications?
What billing considerations apply when reviewing anti-infective drug costs across different medications in this class?
Related pricing data
Data source: National Average Drug Acquisition Cost (NADAC) survey, published by CMS. HCPCS drug pricing codes from Medicare Part B Drug Average Sales Price file.
What NADAC means: The average price pharmacies pay to acquire this drug from wholesalers. Hospital charges for the same drug are typically higher due to facility fees, compounding, and administration costs.
Limitations: NADAC reflects pharmacy acquisition cost, not patient out-of-pocket cost. Insurance copays, formulary tiers, and manufacturer rebates affect what patients actually pay.