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 21 hospitals in the network under the other methodology.
Low
$2
Average
$27
Median
$19
High
$212
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Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 21 hospitals; the 90th percentile is 14.9× 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.
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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Bluffton Health System LLC Bluffton, IN | $14 | $14 | — | — | — | $13 – $48 |
| 2 | Dukes Health System LLC Peru, IN | $22 | $22 | $4 | 18% | — | $13 – $70 |
| 3 | St. Joseph Health System, LLC Wayne, IN | $38 | $38 | — | — | — | $9 – $38 |
| 4 | Wesley Health System LLC Hattiesburg, MS | $212 | $212 | $30 | 14% | — | $27 – $242 |
| 5 | Naples HMA LLC Naples, FL | $22 | $20 | $5 | 25% | — | $4 – $22 |
| 6 | Naples HMA LLC Naples, FL | $22 | $19 | $5 | 27% | — | $4 – $22 |
| 7 | Vicksburg Healthcare LLC Vicksburg, MS | $51 | $49 | $20 | 41% | — | $9 – $68 |
| 8 | Naples HMA LLC Naples, FL | $22 | $20 | $5 | 25% | — | $4 – $22 |
| 9 | Northwest Sahurita Hospital LLC Tucson, AZ | $3 | $3 | $0 | 2% | — | $1 – $11 |
| 10 | Northwest Sahurita Hospital LLC Sahuarita, AZ | $3 | $3 | $0 | 2% | — | $1 – $11 |
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