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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
66658-0505-01	J9210	INJECTION, EMAPALUMAB-LZSG, 1 MG	GAMIFANT (PF) 5 MG/1 ML	IV
66658-0510-01	J9210	INJECTION, EMAPALUMAB-LZSG, 1 MG	GAMIFANT (PF) 5 MG/1 ML	IV
65162-0803-14	None	TEMOZOLOMIDE, 100 MG, ORAL	TEMOZOLOMIDE 100MG	PO
65162-0803-51	None	TEMOZOLOMIDE, 100 MG, ORAL	TEMOZOLOMIDE 100MG	PO
65162-0804-14	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 140MG	PO
65162-0804-51	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 140MG	PO
65162-0805-14	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 180MG	PO
65162-0805-51	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 180MG	PO
65162-0806-51	None	TEMOZOLOMIDE, 250 MG, ORAL	TEMOZOLOMIDE 250MG	PO
65162-0843-06	None	CAPECITABINE, 150 MG, ORAL	CAPECITABINE (USP,FILM COATED) 150 MG	PO
65162-0844-16	None	CAPECITABINE, 500 MG, ORAL	CAPECITABINE (USP,FILM COATED) 500 MG	PO
65162-0914-46	J7682	TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS	TOBRAMYCIN (4 AMPULES X 14 POUCHES) 300 MG/5 ML	IH

HCPCS Code	Description	Billing Unit	SA Type
E0255 RR	Hospital Bed With Mattress And Side Rails	Day	N
E0256 RR	Hospital bed, variable height, hi-lo, with any type side rails, without mattress	Day	N
E0265 RR	Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress	Day	N
E0266 RR	Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, without mattress	Day	N
E0260	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	Each	Y
E0260 RR	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	Day	N
E0261	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress	Each	N
E0261 RR	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress	Day	N
E0271	Mattress Innerspring	Each	N
E0271 RR	Mattress Innerspring	Day	N
E0272	Mattress, foam rubber	Each	N
E0272RR	Mattress, foam rubber	Day	N