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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
71288-0415-06	J7643	GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM	GLYCOPYRROLATE (MDV, USP,LATEX-FREE) 0.2 MG/1 ML	IJ
71288-0415-21	J7643	GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM	GLYCOPYRROLATE (MDV, USP,LATEX-FREE) 0.2 MG/1 ML	IJ
71288-0415-21	J7643	GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM	GLYCOPYRROLATE (MDV, USP,LATEX-FREE) 0.2 MG/1 ML	IJ
71288-0418-10	J1453	INJECTION, FOSAPREPITANT, 1 MG	FOSAPREPITANT DIMEGLUMINE (LATEX-FREE,LYOPHILIZED) 150 MG	IV
71288-0419-96	J1644	INJECTION, HEPARIN SODIUM, PER 1000 UNITS	PREMIERPRO RX HEPARIN SODIUM (SDV;25X1ML,LATEX-FREE) 1000 U/1 ML	IJ
71288-0420-96	J1644	INJECTION, HEPARIN SODIUM, PER 1000 UNITS	PREMIERPRO RX HEPARIN SODIUM (MDV,25X10ML,LATEX-FREE) 1000 U/1 ML	IJ
71288-0421-96	J1644	INJECTION, HEPARIN SODIUM, PER 1000 UNITS	PREMIERPRO RX HEPARIN SODIUM (MDV,25X30ML,LATEX-FREE) 1000 U/1 ML	IJ
71288-0422-96	J1644	INJECTION, HEPARIN SODIUM, PER 1000 UNITS	PREMIERPRO RX HEPARIN SODIUM (SDV;25X1ML,LATEX-FREE) 5000 U/1 ML	IJ
75834-0132-05	None	TEMOZOLOMIDE, 5 MG, ORAL	TEMOZOLOMIDE 5 MG	PO
75834-0132-14	None	TEMOZOLOMIDE, 5 MG, ORAL	TEMOZOLOMIDE 5 MG	PO
75834-0142-05	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 20 MG	PO
75834-0142-14	None	TEMOZOLOMIDE, 20 MG, ORAL	TEMOZOLOMIDE 20 MG	PO

HCPCS Code	Description	Billing Unit	SA Type
E1236 RR	Wheelchair, Pediatric Size, Folding, Adjustable, With Seating System	Day	Y
E1237	Wheelchair, Pediatric Size, Rigid, Adjustable, Without Seating System	Each	Y
E1237 RR	Wheelchair, Pediatric Size, Rigid, Adjustable, Without Seating System	Day	Y
E1238	Wheelchair, Pediatric Size, Folding, Adjustable, Without Seating System	Each	Y
E1238 RR	Wheelchair, Pediatric Size, Folding, Adjustable, Without Seating System	Day	Y
E1240	Lightweight Wheelchair, Detachable Arms, (Desk Or Full Length) Swing Away, Detachable Elevating Leg Rests	Each	N
E1240 RR	Lightweight Wheelchair, Detachable Arms, (Desk Or Full Length), Swing Away, Detachable Elevating Leg Rests	Day	N
E1250	Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Foot Rests	Each	N
E1250 RR	Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Foot Rests	Day	N
E1260	Lightweight Wheelchair, Detachable Arms Desk Or Full Length, Swing Away, Detachable Footrests	Each	N
E1260 RR	Lightweight Wheelchair, Detachable Arms, Desk Or Full Length, Swing Away, Detachable Footrests	Day	N
E1270	Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Elevating Leg Rests	Each	N