HCPCS S0028
Injection, famotidine, 20 mg
Retired code12 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | — | $1.00 |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | — | — |
| Skagit Valley Hospital | — | $3.20 | $4.00 |
| Virginia Mason Medical Center | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.