| HCPCS Code: |
S0164 |
| Long Description: |
Injection, pantoprazole sodium, 40 mg |
| Short Description: |
Injection pantroprazole |
| Pricing Indicator 1: |
00 (Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)) |
| Multiple Pricing Code: |
9 (Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is 99)) |
| Statute Number: |
|
| Coverage Code: |
I (Not payable by Medicare) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
Z2 (Undefined codes) |
| Type of Service Code 1: |
9 (Other medical items or services) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-04-2004 |
| Action Effective Date: |
01-04-2004 |
| Action Code: |
N (No maintenance for this code) |
