2025 HCPCS Code S0104

Zidovudine, oral, 100 mg

Short Description	Zidovudine, oral, 100 mg
HCPCS Action Code	N - No maintenance for this code
HCPCS Coverage Code	I - Not payable by Medicare
HCPCS Code Added Date	October 01, 2002
HCPCS Action Effective Date	October 01, 2002
HCPCS Pricing Indicator Code	00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Type Of Service Code	1 - Medical care
HCPCS Multiple Pricing Indicator 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')
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Coverage Issues Manual Reference Section Number

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