WELCOME

NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
69097-0536-37	J1071	INJECTION, TESTOSTERONE CYPIONATE, 1 MG	TESTOSTERONE CYPIONATE (USP,MDV) 100 MG/1 ML	IM
69097-0537-31	J1071	INJECTION, TESTOSTERONE CYPIONATE, 1 MG	TESTOSTERONE CYPIONATE (USP,SDV) 200 MG/1 ML	IM
69097-0537-37	J1071	INJECTION, TESTOSTERONE CYPIONATE, 1 MG	TESTOSTERONE CYPIONATE (USP,MDV) 200 MG/1 ML	IM
69097-0614-37	J2370	INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML	PHENYLEPHRINE HCL 10 MG/1 ML	IV
69097-0802-32	J1071	INJECTION, TESTOSTERONE CYPIONATE, 1 MG	TESTOSTERONE CYPIONATE 200 MG/1 ML	IM
69097-0802-37	J1071	INJECTION, TESTOSTERONE CYPIONATE, 1 MG	TESTOSTERONE CYPIONATE 200 MG/1 ML	IM
69097-0805-40	J9025	INJECTION, AZACITIDINE, 1 MG	AZACITIDINE (SDV) 100 MG	IJ
69097-0807-37	J0878	INJECTION, DAPTOMYCIN, 1 MG	DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG	IV
69097-0820-96	J0291	INJECTION, PLAZOMICIN, 5 MG	ZEMDRI (SDV,PF) 50 MG/1 ML	IV
69097-0830-37	J1453	INJECTION, FOSAPREPITANT, 1 MG	FOSAPREPITANT DIMEGLUMINE (SDV,LYOPHILIZED) 150 MG	IV
69097-0840-53	J7620	ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME	IPRATROPIUM BROMIDE-ALBUTEROL SULFATE 3 MG/3 ML-0.5 MG/3 ML	IH
69097-0840-64	J7620	ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME	IPRATROPIUM BROMIDE-ALBUTEROL SULFATE (60X3ML;SDV) 3 MG/3 ML-0.5 MG/3 ML	IH

HCPCS Code	Description	Billing Unit	SA Type
L3465	Heel, Thomas with wedge	Each	Y
L3470	Heel, Thomas extended to ball	Each	Y
L3480	Heel, pad and depression for spur	Each	Y
L3485	Heel, pad, removable for spur	Each	Y
L2768	Orthotic side bar disconnect device, per bar	Each	Y
L2780	Addition to lower extremity orthosis, noncorrosive finish, per bar	Each	Y
L2785	Addition to lower extremity orthosis, drop lock retainer, each	Each	Y
L2795	Addition to lower extremity orthosis, knee control, full knee cap	Each	Y
L2800	Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only	Each	Y
L2810	Addition to lower extremity orthosis, knee control, condylar pad	Each	Y
L2820	Addition to lower extremity orthosis, soft interface for molded plastic, below knee section	Each	Y
L2830	Addition to lower extremity orthosis, soft interface for molded plastic, above knee section	Each	Y