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NDC 65628027210

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

Reported by 38 hospitals in the network under the percent of billed charges methodology.

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.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

$8

Average

$345

Median

$411

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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