C9113

Short Description

• Inj pantoprazole sodium, via

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2002

HCPCS Code Added Date

• January 01, 2002

HCPCS Pricing Indicator Code

• 53 = Statute

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Statute Number

• 1833(T)

HCPCS Type Of Service Code

• 9 = Other medical items or services

HCPCS Anesthesia Base Unit Quantity

• 0