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NDC 00904-2725-61

SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET

Reported by 40 hospitals in the network.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

National pricing summary

Low

$0

Average

$5

Median

$1

High

$50

Hospitals reporting this code

#HospitalLocation
1Vanderbilt Wilson County HospitalLebanon, TN$0$1$0$1$0
2Vanderbilt Tullahoma-Harton HospitalTullahoma, TN$0$1$0$1$0
3Vanderbilt University Medical CenterNashville, TN$0$0$0$1$0
4Vanderbilt Bedford HospitalShelbyville, TN$0$1$0$1$0
5MaineHealthBrunswick, ME$1$1$1$1$0
6MaineHealthNorth Conway, NH$0$1$1$1$0
7MaineHealthBelfast, ME$0$1$1$1$0
8MaineHealthWestbrook, ME$2$3$3$4$1
9Mary Hitchcock Memorial HospitalLebanon, NH$6$33$33$49$12
10Cheshire Medical CenterKeene, NH$7$38$34$54$13
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