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  3. /St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional Hospital
  4. /NDC 72572001710

NDC 72572001710

AMPICILLIN 2 GRAM SOLUTION FOR INJECTION at St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional Hospital

JUNCTION, CO

Pricing by billing methodology

Price type

All methodologies

$17

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

$17

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: Mar 22, 2026

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