NDC 00121-0504-40
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
acetaminophen-codeine 120 mg-12 mg/5 mL Soln 5 mL
Low
$25
Average
$40
Median
$28
High
$79
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Allina Health Systems Buffalo, MN | $29 | $28 | $12 | 43% | — | $0 – $56 |
| 2 | Allina Health Systems Faribualt, MN | $29 | $28 | $12 | 43% | — | $0 – $56 |
| 3 | Allina Health Systems River Falls, WI | $25 | $25 | $3 | 11% | — | $11 – $56 |
| 4 | Glenwood Regional Medical Center - HSA West Monroe, LA | $79 | $79 | — | — | — | $12 – $138 |
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