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  3. /The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania
  4. /NDC 72205017072

NDC 72205017072

ACYCLOVIR 200 MG 5ML PO SUSP at The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania

Philadelphia, PA

Pricing by billing methodology

Price type

All methodologies

$856

Aggregated across all available billing methodologies for this code.

Case rate

$1.3k

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

Fee schedule

$1.3k

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

$771

Reflects a negotiated percentage of total billed charges.

Other

$1.3k

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

Last updated: Feb 10, 2026

Compare to other hospitals

See ACYCLOVIR 200 MG 5ML PO SUSP pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.

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