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HCPCS Details
| HCPC | S0104 |
| Short Description | Zidovudine, oral, 100 mg |
| Long Description | Zidovudine, oral, 100 mg |
| Pricing indicator | 00 |
| Coverage code | I |
| ASC payment group code | |
| BETOS2 code | Z2 |
| Action code | N |
| Type of service | 1 |
| Effective date | 2002-10-01 |
| Date Added | 2002-10-01 |