NDC 904674172
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
00904-6741-72 - diphenhydrAMINE 12.5 mg/5 mL Liqui
Low
$1
Average
$4
Median
$4
High
$10
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. 6 hospitals; the 90th percentile is 11.1× 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 | St. Joseph Health System, LLC Wayne, IN | $10 | $10 | — | — | — | $2 – $10 |
| 2 | Affinity Hospital LLC Birmingham, AL | $3 | $3 | $1 | 25% | — | $1 – $4 |
| 3 | Gadsden Regional Medical Center LLC Gadsden, AL | $4 | $4 | — | — | — | $4 – $4 |
| 4 | La Porte Hospital Company LLC La Porte, IN | $1 | $1 | — | — | — | $1 – $3 |
| 5 | Knox Hospital Company LLC Knox, IN | $1 | $1 | — | — | — | $1 – $3 |
| 6 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $9 | $7 | $3 | 47% | — | $1 – $9 |
Ask Claude or any MCP client for NDC 904674172 pricing at a specific hospital — see how to connect.