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NDC 9999910973

RX AMOXICILLIN-POT CLAVULANATE 400-57 MG/5 ML SUSP 100 ML TAKE HOME

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

$29

Average

$38

Median

$38

High

$50

Hospitals reporting this code

#HospitalLocationApproximate 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.
1Catholic Health Initiatives ColoradoColorado Springs, CO$30$32$13—$15$55
2Catholic Health Initiatives ColoradoSalt Lake City, UT$34$38$11—$22$62
3Catholic Health Initiatives ColoradoColorado Springs, CO$31$36$12—$17$55
4Catholic Health Initiatives ColoradoLehi, UT$34$38$11—$22$62
5St Francis HospitalColorado Springs, CO$28$30$11—$15$53
6Longmont United HospitalLongmont, CO$25$30$13—$15$56
7Catholic Health Initiatives ColoradoFrisco, CO$37$41$13—$17$57
8Commonspirit Kansas, Inc.Ulysses, KS$52$43$16—$20$59
9Commonspirit Kansas, Inc.Dodge City, KS$50$48$9—$22$56
10Catholic Health Initiatives ColoradoPueblo, CO$36$37$13—$17$55
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Look up this code directly

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