NDC 00904-7237-24
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.
Generation details were not recorded for this description.
Original text from hospital filings
DIPHENHYDRAMINE 25MG CAPSULE
Reported by 8 hospitals in the network under the other methodology.
Based on 441–585 billing samples across every hospital reporting.
Low
$7
Average
$15
Median
$8
High
$35
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. 8 hospitals; the 90th percentile is 4.8× 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 | Northside Hospital, Inc. | Lawrenceville, GA | $5 | $8 | $5 | 139–166 | $0 | $25 |
| 2 | Northside Hospital, Inc. | Atlanta, GA | $5 | $8 | $5 | 130–139 | $0 | $25 |
| 3 | Northside Hospital, Inc. | Cumming, GA | $4 | $8 | $6 | 98–116 | $0 | $25 |
| 4 | Northside Hospital, Inc. | Canton, GA | $4 | $7 | $6 | 66–84 | $0 | $25 |
| 5 | Northside Hospital, Inc. | Duluth, GA | $4 | $7 | $6 | 6–60 | $0 | $25 |
| 6 | Norton Hospitals INC | Louisville, KY | $7 | $7 | — | 2–20 | $0 | $7 |
| 7 | Nebraska Medical Center | Omaha, NE | $29 | $35 | $15 | — | $2 | $75 |
| 8 | Bellevue Medical Center Llc | Bellevue, NE | $29 | $35 | $15 | — | $2 | $75 |
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