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
$11
Average
$20
Median
$19
High
$30
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Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 7 hospitals; the 90th percentile is 2.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Bluffton Health System LLC Bluffton, IN | $11 | $11 | $10 | 86% | — | $1 – $73 |
| 2 | Dukes Health System LLC Peru, IN | $9 | $13 | $12 | 87% | — | $1 – $78 |
| 3 | St. Joseph Health System, LLC Wayne, IN | $23 | $23 | $19 | 84% | — | $1 – $42 |
| 4 | Oro Valley Hospital LLC Tucson, AZ | $24 | $30 | $9 | 31% | — | $12 – $81 |
| 5 | Northwest Hospital LLC Tucson, AZ | $24 | $30 | $10 | 32% | — | $12 – $81 |
| 6 | Crestview Hospital Corporation Crestview, FL | $5 | $19 | $37 | 194% | — | $1 – $117 |
| 7 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $20 | $15 | $7 | 47% | — | $2 – $20 |
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