NDC 904043004
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
00904-0430-04 - doxycycline hyclate 100 mg Tab
Reported by 44 hospitals in the network under the percent of billed charges methodology.
Based on 460–478 billing samples across every hospital reporting.
Low
$0
Average
$74
Median
$6
High
$421
Filter by billing methodology
Reflects a negotiated percentage of total billed charges.
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter above to change the chart. 44 hospitals; the 90th percentile is 276.9× 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.
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 | Tri-City Medical Center | Oceanside, CA | $13 | $17 | $8 | 460–478 | $6 | $30 |
| 2 | IOM Health System LP | Fort Wayne, IN | $6 | $6 | $2 | — | $3 | $11 |
| 3 | Lutheran Musculoskeletal Center LLC | Fort Wayne, IN | $11 | $12 | $4 | — | $6 | $23 |
| 4 | St. Joseph Health System, LLC | Wayne, IN | $8 | $8 | $3 | — | $3 | $14 |
| 5 | Durant HMA LLC | Durant, OK | $3 | $2 | $1 | — | $1 | $3 |
| 6 | Naples HMA LLC | Naples, FL | $3 | $5 | $2 | — | $2 | $13 |
| 7 | Naples HMA LLC | Naples, FL | $3 | $5 | $2 | — | $2 | $13 |
| 8 | Vicksburg Healthcare LLC | Vicksburg, MS | $6 | $7 | $4 | — | $3 | $19 |
| 9 | Naples HMA LLC | Naples, FL | $3 | $5 | $2 | — | $2 | $13 |
| 10 | Northwest Sahurita Hospital LLC | Tucson, AZ | $0 | $0 | $0 | — | $0 | $2 |
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