NDC 121050404
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
00121-0504-04 - acetaminophen-codeine 120 mg-12 mg
Low
$0
Average
$10
Median
$11
High
$20
Filter by billing methodology
Reflects negotiated fee schedule rates with commercial payers.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Dukes Health System LLC Peru, IN | $9 | $11 | $11 | 99% | — | $1 – $78 |
| 2 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $20 | $20 | — | — | — | $2 – $20 |
| 3 | Hillsdale Hospital Hillsdale, MI | $0 | $0 | — | — | — | $0 – $5 |
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