NDC 121064616
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
00121-0646-16 - amantadine 50mg/5mL Oral Syrup 10
Reported by 16 hospitals in the network under the other methodology.
Low
$1
Average
$20
Median
$6
High
$157
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 16 hospitals; the 90th percentile is 34.1× 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 | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Bluffton Health System LLC Bluffton, IN | $2 | $2 | $1 | 33% | — | $1 – $11 |
| 2 | Dukes Health System LLC Peru, IN | $2 | $2 | $1 | 24% | — | $1 – $9 |
| 3 | St. Joseph Health System, LLC Wayne, IN | $5 | $5 | $2 | 33% | — | $1 – $6 |
| 4 | Wesley Health System LLC Hattiesburg, MS | $12 | $12 | $2 | 14% | — | $2 – $14 |
| 5 | Vicksburg Healthcare LLC Vicksburg, MS | $13 | $12 | $5 | 41% | — | $2 – $17 |
| 6 | Northwest Hospital LLC Tucson, AZ | $7 | $9 | $3 | 32% | — | $4 – $24 |
| 7 | Affinity Hospital LLC Birmingham, AL | $38 | $38 | $10 | 25% | — | $7 – $48 |
| 8 | Crestview Hospital Corporation Crestview, FL | $16 | $61 | $119 | 194% | — | $3 – $378 |
| 9 | HMA Santa Rosa Medical Center LLC Milton, FL | $3 | $10 | $20 | 194% | — | $1 – $63 |
| 10 | Laredo Texas Hospital Company LP Laredo, TX | $1 | $1 | $0 | 3% | — | $1 – $10 |
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