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Official Description

Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)
Short Descr Amantadine hcl oral brand
Coverage Carrier Priced
Pricing Indicator(s) 13 – Physician Fee Schedule - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion)
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS O1E – Other drugs
TOS Code(s) 1 – Medical care
Added Date 12/1/2004
Termination Date 12/31/2019
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2019-12-31 Deleted Code deleted.
2004-12-01 Added Code added 12/1/2004
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