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NDC 1671429501

AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET

Reported by 20 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

$9

Average

$12

Median

$12

High

$16

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$5$10$10$18$4
2Catholic Health Initiatives ColoradoSalt Lake City, UT$7$11$12$20$4
3Catholic Health Initiatives ColoradoColorado Springs, CO$5$10$12$18$4
4Catholic Health Initiatives ColoradoLehi, UT$7$11$12$20$4
5St Francis HospitalColorado Springs, CO$5$9$10$17$4
6Longmont United HospitalLongmont, CO$5$8$10$18$4
7Catholic Health Initiatives ColoradoFrisco, CO$5$12$13$19$4
8Commonspirit Kansas, Inc.Ulysses, KS$6$17$14$19$5
9Commonspirit Kansas, Inc.Dodge City, KS$7$16$15$18$3
10Catholic Health Initiatives ColoradoPueblo, CO$6$12$12$18$4
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