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  3. /IHC Health Services Inc., DBA Intermountain Health Layton Hospital
  4. /NDC 67457077930

NDC 67457077930

SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION at IHC Health Services Inc., DBA Intermountain Health Layton Hospital

Layton, UT

Pricing by billing methodology

Price type

All methodologies

$161

Aggregated across all available billing methodologies for this code.

Case rate

Not reported

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

Not reported

Reflects negotiated fee schedule rates with commercial payers.

Per diem

Not reported

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$161

Reflects a negotiated percentage of total billed charges.

Other

Not reported

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Aug 5, 2026

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