NDC 121115440
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
00121-1154-40 - lactulose 20 gm Syrup 30 mL UD
Reported by 27 hospitals in the network under the other methodology.
Based on 9–90 billing samples across every hospital reporting.
Low
$2
Average
$13
Median
$6
High
$47
Filter by billing methodology
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. 27 hospitals; the 90th percentile is 13.7× 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 | Naples HMA LLC | Naples, FL | $51 | $47 | $12 | 4–40 | $9 | $51 |
| 2 | Naples HMA LLC | Naples, FL | $51 | $47 | $12 | 4–40 | $9 | $51 |
| 3 | Oro Valley Hospital LLC | Tucson, AZ | $2 | $3 | $1 | 1–10 | $1 | $8 |
| 4 | Bluffton Health System LLC | Bluffton, IN | $10 | $10 | — | — | $10 | $36 |
| 5 | Dukes Health System LLC | Peru, IN | $13 | $13 | $2 | — | $8 | $41 |
| 6 | St. Joseph Health System, LLC | Wayne, IN | $28 | $28 | — | — | $7 | $28 |
| 7 | Natchez Hospital Company LLC | Natchez, MS | $14 | $12 | $5 | — | $1 | $16 |
| 8 | Naples HMA LLC | Naples, FL | $51 | $45 | $12 | — | $9 | $51 |
| 9 | Northwest Sahurita Hospital LLC | Tucson, AZ | $2 | $2 | $0 | — | $1 | $8 |
| 10 | Northwest Sahurita Hospital LLC | Sahuarita, AZ | $2 | $2 | $0 | — | $1 | $8 |
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