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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
61314-0304-01	Q5101	INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM	ZARXIO (PF) 300 MCG/0.5 ML	IJ
61314-0318-01	Q5101	INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM	ZARXIO (PF) 300 MCG/0.5 ML	IJ
61314-0318-10	Q5101	INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM	ZARXIO (PF) 300 MCG/0.5 ML	IJ
61314-0326-01	Q5101	INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM	ZARXIO (PF) 480 MCG/0.8 ML	IJ
61314-0326-10	Q5101	INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM	ZARXIO (PF) 480 MCG/0.8 ML	IJ
61442-0114-01	J8499	PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS	ACYCLOVIR (USP) 200 MG	PO
61442-0114-05	J8499	PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS	ACYCLOVIR (USP) 200 MG	PO
61553-0107-02	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 0.5 MG/100 ML-0.9%	IV
61553-0109-72	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE/SODIUM CHLORIDE (SRN,12 ML) 0.5 MG/100 ML-0.9%	IV
61553-0111-48	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 1 MG/100 ML-0.9%	IV
61553-0112-48	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE/SODIUM CHLORIDE (IPUMP BAG) 1 MG/100 ML-0.9%	IV
61553-0113-02	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 1 MG/100 ML-0.9%	IV

HCPCS Code	Description	Billing Unit	SA Type
A7005	Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable	Each	N
A7006	Administration set, with small volume filter pneumatic nebulizer	Each	N
A7007	Large voume nebulizer, disposable, unfilled, used with aerosol compressor	Each	N
A7008	Large volume nebulizer, disposable, Prefilled, used with aerosol compressor	Each	N