NDC 904506860
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
00904-5068-60 - simethicone 80. mg Tab-Chew
Reported by 6 hospitals in the network under the fee schedule methodology.
Low
$0
Average
$1
Median
$1
High
$4
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Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 6 hospitals; the 90th percentile is 6.8× 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 | Std dev | 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 | Dukes Health System LLC | Peru, IN | $0 | $0 | $0 | — | $0 | $1 |
| 2 | Laredo Texas Hospital Company LP | Laredo, TX | $0 | $0 | $0 | — | $0 | $6 |
| 3 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania | Philadelphia, PA | $1 | $1 | — | — | $0 | $1 |
| 4 | Westchester Medical Center | Valhalla, NY | $1 | $1 | — | — | $0 | $1 |
| 5 | Mid Hudson Regional Hospital | Poughkeepsie, NY | $1 | $1 | — | — | $0 | $1 |
| 6 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System | Houma, LA | $4 | $4 | — | — | $1 | $4 |
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