| HCPCS Code: |
G9017 |
| Long Description: |
Amantadine hydrochloride, oral, per 100 mg (for use in a medicare-approved demonstration project) |
| Short Description: |
Amantadine hcl 100mg oral |
| Pricing Indicator 1: |
13 (Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
|
| Coverage Code: |
C (Carrier judgment) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
O1E (Other drugs) |
| Type of Service Code 1: |
1 (Medical care) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-12-2004 |
| Action Effective Date: |
01-12-2004 |
| Action Code: |
N (No maintenance for this code) |
