NDC 406048462
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
00406-0484-62 - acetaminophen-codeine 300 mg-30 mg
Reported by 39 hospitals in the network under the other methodology.
Based on 7–70 billing samples across every hospital reporting.
Low
$1
Average
$7
Median
$5
High
$38
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 39 hospitals; the 90th percentile is 17.8× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | Location | Approximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | Natchez Hospital Company LLC | Natchez, MS | $8 | $7 | $3 | 1–10 | $0 | $9 |
| 2 | Naples HMA LLC | Naples, FL | $13 | $11 | $3 | 1–10 | $2 | $13 |
| 3 | Victoria of Texas LP | Victoria, TX | $4 | $6 | $6 | 1–10 | $1 | $22 |
| 4 | Victoria of Texas LP | Victoria, TX | $4 | $6 | $6 | 1–10 | $1 | $22 |
| 5 | Crestview Hospital Corporation | Crestview, FL | $4 | $17 | $32 | 1–10 | $1 | $102 |
| 6 | Longview Medical Center LP | Longview, TX | $2 | $5 | $4 | 1–10 | $1 | $18 |
| 7 | USC Arcadia Hospital | Arcadia, CA | $10 | $10 | $1 | 1–10 | $6 | $17 |
| 8 | Bluffton Health System LLC | Bluffton, IN | $4 | $4 | — | — | $4 | $14 |
| 9 | Dukes Health System LLC | Peru, IN | $3 | $3 | $0 | — | $1 | $8 |
| 10 | St. Joseph Health System, LLC | Wayne, IN | $5 | $5 | — | — | $1 | $5 |
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