NDC 00004-6912-06
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
UNCLASSIFIED DRUGS
Reported by 22 hospitals in the network.
Based on 360–576 billing samples across every hospital reporting.
Low
$8
Average
$302
Median
$146
High
$967
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Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 22 hospitals; the 90th percentile is 5.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | Location | Approximate 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. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | Lodi Memorial Hospital Association Inc | Lodi, CA | $230 | $236 | $110 | 255–336 | $88 | $484 |
| 2 | Saint Clares Hospital | Denville, NJ | $8 | $8 | — | 77 | $8 | $8 |
| 3 | White Memorial Medical Center | Angeles, CA | $84 | $88 | $57 | 23–113 | $24 | $353 |
| 4 | Glendale Adventist Medical Center | Glendale, CA | $163 | $212 | $135 | 5–50 | $86 | $719 |
| 5 | Dignity Community Care | Sacramento, CA | $770 | $695 | $249 | — | $100 | $951 |
| 6 | Dignity Health | Sacramento, CA | $742 | $692 | $171 | — | $238 | $951 |
| 7 | Dignity Health | Folsom, CA | $756 | $667 | $244 | — | $105 | $951 |
| 8 | Sierra Nevada Memorial-miners Hospital | Grass Valley, CA | $724 | $721 | $104 | — | $408 | $832 |
| 9 | Dignity Health | Carmichael, CA | $713 | $670 | $245 | — | $105 | $951 |
| 10 | Dignity Health | Redding, CA | $994 | $967 | $91 | — | $812 | $1.1k |
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