Showing codes S0106 (Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets) — S0176 (Hydroxyurea, oral, 500 mg)

S0106 - Bupropion hcl sr 60 tablets
Long description: Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets
Code added date: 20020401.
Code effective date: 20020401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0108 - Mercaptopurine 50 mg
Long description: Mercaptopurine, oral, 50 mg
Code added date: 20020401.
Code effective date: 20020401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0109 - Methadone oral 5mg
Long description: Methadone, oral, 5 mg
Code added date: 20041001.
Code effective date: 20041001.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0117 - Tretinoin topical 5 g
Long description: Tretinoin, topical, 5 grams
Code added date: 20040701.
Code effective date: 20040701.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0119 - Ondansetron 4 mg
Long description: Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0122 - Inj menotropins 75 iu
Long description: Injection, menotropins, 75 iu
Code added date: 20020401.
Code effective date: 20020401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0126 - Inj follitropin alfa 75 iu
Long description: Injection, follitropin alfa, 75 iu
Code added date: 20020401.
Code effective date: 20020401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0128 - Inj follitropin beta 75 iu
Long description: Injection, follitropin beta, 75 iu
Code added date: 20020401.
Code effective date: 20020401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0132 - Inj ganirelix acetat 250 mcg
Long description: Injection, ganirelix acetate, 250 mcg
Code added date: 20020401.
Code effective date: 20020401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0136 - Clozapine, 25 mg
Long description: Clozapine, 25 mg
Code added date: 20030401.
Code effective date: 20030401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0137 - Didanosine, 25 mg
Long description: Didanosine (ddi), 25 mg
Code added date: 20030401.
Code effective date: 20030401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0138 - Finasteride, 5 mg
Long description: Finasteride, 5 mg
Code added date: 20030401.
Code effective date: 20030401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0139 - Minoxidil, 10 mg
Long description: Minoxidil, 10 mg
Code added date: 20030401.
Code effective date: 20030401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0140 - Saquinavir, 200 mg
Long description: Saquinavir, 200 mg
Code added date: 20030401.
Code effective date: 20030401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0142 - Colistimethate inh sol mg
Long description: Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg
Code added date: 20050401.
Code effective date: 20050401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0144 - Inj, propofol, 10 mg
Long description: Injection, propofol, 10 mg
Code added date: 20140701.
Code effective date: 20150101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0145 - Peg interferon alfa-2a/180
Long description: Injection, pegylated interferon alfa-2a, 180 mcg per ml
Code added date: 20050701.
Code effective date: 20050701.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0148 - Peg interferon alfa-2b/10
Long description: Injection, pegylated interferon alfa-2b, 10 mcg
Code added date: 20101001.
Code effective date: 20101001.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0155 - Epoprostenol dilutant
Long description: Sterile dilutant for epoprostenol, 50 ml
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0156 - Exemestane, 25 mg
Long description: Exemestane, 25 mg
Code added date: 20010101.
Code effective date: 20010101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0157 - Becaplermin gel 1%, 0.5 gm
Long description: Becaplermin gel 0.01%, 0.5 gm
Code added date: 20010101.
Code effective date: 20010101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0160 - Dextroamphetamine
Long description: Dextroamphetamine sulfate, 5 mg
Code added date: 20040401.
Code effective date: 20040401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0164 - Injection pantroprazole
Long description: Injection, pantoprazole sodium, 40 mg
Code added date: 20040401.
Code effective date: 20040401.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0166 - Inj olanzapine 2.5mg
Long description: Injection, olanzapine, 2.5 mg
Code added date: 20041001.
Code effective date: 20231001.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0169 - Calcitrol
Long description: Calcitrol, 0.25 microgram
Code added date: 20101001.
Code effective date: 20101001.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0170 - Anastrozole 1 mg
Long description: Anastrozole, oral, 1 mg
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0171 - Bumetanide 0.5 mg
Long description: Injection, bumetanide, 0.5 mg
Code added date: 20020101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0172 - Chlorambucil 2 mg
Long description: Chlorambucil, oral, 2 mg
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0174 - Dolasetron 50 mg
Long description: Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0175 - Flutamide 125 mg
Long description: Flutamide, oral, 125 mg
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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S0176 - Hydroxyurea 500 mg
Long description: Hydroxyurea, oral, 500 mg
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: I (A code denoting Medicare coverage status).
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