HCPCS S0164
Injection, pantoprazole sodium, 40 mg
Retired code13 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.