NDC 00904-6640-61
Bellevue, NE
Price type
All methodologies
$5
Case rate
Not reported
Fee schedule
$9
Per diem
Not reported
Percent of billed charges
$3
Other
$10
Last updated: Aug 10, 2026
See PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.