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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
23155-0345-42	J2704	INJECTION, PROPOFOL, 10 MG	PROPOFOL (20X50ML;USP,PF) 10 MG/1 ML	IV
23155-0345-43	J2704	INJECTION, PROPOFOL, 10 MG	PROPOFOL (10X100ML;USP,PF) 10 MG/1 ML	IV
23155-0345-44	J2704	INJECTION, PROPOFOL, 10 MG	PROPOFOL (20X20ML;USP,PF) 10 MG/1 ML	IV
23155-0473-41	J1940	INJECTION, FUROSEMIDE, UP TO 20 MG	FUROSEMIDE (SDV) 10 MG/ML	IJ
23155-0473-42	J1940	INJECTION, FUROSEMIDE, UP TO 20 MG	FUROSEMIDE (SDV) 10 MG/ML	IJ
23155-0473-44	J1940	INJECTION, FUROSEMIDE, UP TO 20 MG	FUROSEMIDE (SDV) 10 MG/ML	IJ
23155-0485-51	J8499	PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS	ACYCLOVIR (BANANA) 200 MG/5 ML	PO
23155-0521-41	J1940	INJECTION, FUROSEMIDE, UP TO 20 MG	PREMIERPRO RX FUROSEMIDE (SDV) 10 MG/ML	IJ
23155-0521-42	J1940	INJECTION, FUROSEMIDE, UP TO 20 MG	PREMIERPRO RX FUROSEMIDE (SDV) 10 MG/ML	IJ
23155-0521-44	J1940	INJECTION, FUROSEMIDE, UP TO 20 MG	PREMIERPRO RX FUROSEMIDE (SDV) 10 MG/ML	IJ
14789-0109-10	J3480	INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ	POTASSIUM CHLORIDE (LATEX-FREE) 10 MEQ/100 ML	IV
14789-0110-05	J1953	INJECTION, LEVETIRACETAM, 10 MG	LEVETIRACETAM-SODIUM CHLORIDE (LATEX-FREE) 500 MG/100 ML-0.82%	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