NDC 121479905
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
00121-4799-05 - levETIRAcetam 500 mg / 5 mL Soln-O
Reported by 3 hospitals in the network under the fee schedule methodology.
Low
$1
Average
$14
Median
$19
High
$21
Filter by billing methodology
Reflects negotiated fee schedule rates with commercial payers.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Dukes Health System LLC Peru, IN | $14 | $19 | $7 | 40% | — | $13 – $70 |
| 2 | Laredo Texas Hospital Company LP Laredo, TX | $1 | $1 | $0 | 35% | — | $1 – $15 |
| 3 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $21 | $21 | — | — | — | $2 – $21 |
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