NDC 904578961
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
acyclovir 200 mg Cap [CITY]
Reported by 78 hospitals in the network.
Based on 462–498 billing samples across every hospital reporting.
Low
$1
Average
$105
Median
$2
High
$3.9k
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Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 78 hospitals; the 90th percentile is 22.5× 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 | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Tri-City Medical Center Oceanside, CA | $8 | $10 | $5 | 45% | 460–478 | $3 – $18 |
| 2 | Crestview Hospital Corporation Crestview, FL | $21 | $47 | $137 | 290% | 1–10 | $6 – $755 |
| 3 | Navarro Hospital LP Corsicana, TX | $12 | $12 | $6 | 53% | 1–10 | $2 – $24 |
| 4 | IOM Health System LP Fort Wayne, IN | $1 | $1 | $0 | 37% | — | $1 – $2 |
| 5 | Bluffton Health System LLC Bluffton, IN | $3 | $3 | $1 | 34% | — | $1 – $4 |
| 6 | Dukes Health System LLC Peru, IN | $3 | $3 | $1 | 45% | — | $1 – $7 |
| 7 | Warsaw Health System LLC Warsaw, IN | $3 | $3 | $1 | 34% | — | $1 – $5 |
| 8 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN | $2 | $3 | $1 | 35% | — | $1 – $5 |
| 9 | St. Joseph Health System, LLC Wayne, IN | $2 | $2 | $1 | 37% | — | $1 – $3 |
| 10 | Dupont Hospital LLC Wayne, IN | $1 | $1 | $0 | 37% | — | $0 – $2 |
Ask Claude or any MCP client for NDC 904578961 pricing at a specific hospital — see how to connect.