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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
55390-0126-05	J2250	INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG	MIDAZOLAM HCL (VIAL,PF) 5 MG/ML	IJ
55390-0126-10	J2250	INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG	MIDAZOLAM HCL (VIAL,PF) 5 MG/ML	IJ
55390-0137-02	J2250	INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG	MIDAZOLAM HCL (VIAL,PF) 1 MG/ML	IJ
55390-0137-05	J2250	INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG	MIDAZOLAM HCL (VIAL,PF) 1 MG/ML	IJ
55390-0138-01	J2250	INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG	MIDAZOLAM HCL (VIAL,PF) 5 MG/ML	IJ
55390-0138-02	J2250	INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG	MIDAZOLAM HCL (VIAL,PF) 5 MG/ML	IJ
55390-0183-01	J0595	INJECTION, BUTORPHANOL TARTRATE, 1 MG	BUTORPHANOL TARTRATE (S.D.V.) 1 MG/ML	IJ
55390-0184-01	J0595	INJECTION, BUTORPHANOL TARTRATE, 1 MG	BUTORPHANOL TARTRATE (S.D.V.) 2 MG/ML	IJ
55390-0308-03	J0207	INJECTION, AMIFOSTINE, 500 MG	AMIFOSTINE (3X10ML,LYOPHILIZED) 500 MG	IV
55390-0480-01	J1885	INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG	KETOROLAC TROMETHAMINE (S.D.V.) 15 MG/ML	IJ
55390-0481-01	J1885	INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG	KETOROLAC TROMETHAMINE (S.D.V.) 30 MG/ML	IJ
50242-0132-10	J9355	INJECTION, TRASTUZUMAB, 10 MG	HERCEPTIN (SDV,PF,LYPHOLIZED) 150 MG	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