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NDC 63629214301

MEMANTINE 28 MG CAPSULE SPRINKLE,EXTENDED RELEASE 24HR

Reported by 13 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 13,760–13,985 billing samples across every hospital reporting.

Low

$114

Average

$127

Median

$124

High

$174

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.
1North Carolina Baptist HospitalBermuda Run, NC$131$174$893,090–3,126$74$356
2Atrium Health Hospitals IncShelby, NC$122$121$612,426–2,453$32$220
3The Charlotte Mecklenburg Hospital AuthorityMonroe, NC$108$120$602,347–2,374$30$220
4The Charlotte Mecklenburg Hospital AuthorityConcord, NC$116$118$612,206–2,260$28$220
5The Charlotte Mecklenburg Hospital AuthorityCharlotte, NC$116$118$611,931–1,958$23$225
6The Charlotte Mecklenburg Hospital AuthorityAlbermarle, NC$139$134$66981$28$222
7The Charlotte Mecklenburg Hospital AuthorityCharlotte, NC$112$117$59761–788$23$213
8Carolinas Medical CenterCharlotte, NC$123$125$6316–25$44$232
9Carolinas Medical CenterCharlotte, NC$120$127$521–10$50$208
10Carolinas Medical CenterCharlotte, NC$116$124$511–10$50$213
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