NDC 904043006
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
00904-0430-06 - doxycycline 100 mg / 1 tab(s) Tab
Reported by 15 hospitals in the network under the other methodology.
Based on 13–130 billing samples across every hospital reporting.
Low
$0
Average
$5
Median
$4
High
$14
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. 15 hospitals; the 90th percentile is 22.4× 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 | $13 | $12 | $3 | 4–40 | $2 | $13 |
| 2 | Naples HMA LLC | Naples, FL | $13 | $12 | $3 | 4–40 | $2 | $13 |
| 3 | Naples HMA LLC | Naples, FL | $13 | $11 | $3 | 3–30 | $2 | $13 |
| 4 | Northwest Sahurita Hospital LLC | Tucson, AZ | $0 | $0 | $0 | 1–10 | $0 | $2 |
| 5 | Northwest Sahurita Hospital LLC | Sahuarita, AZ | $0 | $0 | $0 | 1–10 | $0 | $2 |
| 6 | St. Joseph Health System, LLC | Wayne, IN | $14 | $14 | — | — | $3 | $14 |
| 7 | Northwest Hospital LLC | Tucson, AZ | $0 | $1 | $0 | — | $0 | $2 |
| 8 | Foley Hospital Company LLC | Foley, AL | $7 | $7 | $6 | — | $1 | $13 |
| 9 | Gadsden Regional Medical Center LLC | Gadsden, AL | $2 | $2 | — | — | $2 | $2 |
| 10 | Laredo Texas Hospital Company LP | Laredo, TX | $4 | $4 | $0 | — | $2 | $36 |
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