NDC 00121-0489-00

DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN

Reported by 2 hospitals in the network under the other methodology.

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

National pricing summary

Low

$13

Average

$14

Median

$14

High

$14

Hospitals reporting NDC 00121-0489-00

#	Hospital	Location
1	Nebraska Medical Center	Omaha, NE	$11	$13	$6	—	$2	$29
2	Bellevue Medical Center Llc	Bellevue, NE	$13	$14	$6	—	$2	$32

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