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NDC 65628027210

OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML PO SUSR

Reported by 37 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

Low

$8

Average

$354

Median

$412

High

$510

Hospitals reporting this code

#HospitalLocation
1University of Iowa Health Care Medical Center DowntownIowa City, IA$132$496$506$702$147
2University of Iowa Health Care Medical CenterIowa City, IA$191$511$510$702$142
3Sanford Fargo Medical CenterFargo, ND$4$10$9$12$3
4Sanford Medical Center BismarckBismarck, ND$4$8$8$10$2
5Sanford Bemidji Medical CenterBemidji, MN$6$11$10$12$2
6Sanford USD Medical CenterSioux Falls, SD$8$21$19$27$7
7Baylor Scott & White Medical Center - TempleTemple, TX$105$399$404$630$117
8Baylor Scott & White Medical Center - BrenhamBrenham, TX$86$371$314$630$173
9Baylor Scott & White Medical Center - TaylorTaylor, TX$133$378$336$560$144
10Baylor Scott & White Medical Center - HillcrestWaco, TX$84$385$381$595$109
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