NDC 00904-6084-61
Omaha, NE
Price type
All methodologies
$18
Case rate
Not reported
Fee schedule
$24
Per diem
Not reported
Percent of billed charges
$9
Other
$18
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.