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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
68330-0004-01	J0696	INJECTION, CEFTRIAXONE SODIUM, PER 250 MG	CEFTRIAXONE (USP) 2 GM	IJ
63323-0751-13	J2371	INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS	PHENYLEPHRINE HCL NOVAPLUS 10 MG/1 ML	IV
63323-0760-20	J9245	INJECTION, MELPHALAN HYDROCHLORIDE, 50 MG	MELPHALAN HYDROCHLORIDE (W/10ML DILUENT) 50 MG	IV
63323-0771-39	J9025	INJECTION, AZACITIDINE, 1 MG	AZACITIDINE (SDV) 100 MG	IJ
63323-0778-10	J2800	INJECTION, METHOCARBAMOL, UP TO 10 ML	METHOCARBAMOL (LATEX-FREE) 100 MG/1 ML	IJ
63323-0806-01	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE (SDV,PF,LATEX-FREE) 50 MCG/1 ML	IJ
63323-0806-02	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE (SDV,PF,LATEX-FREE) 50 MCG/1 ML	IJ
63323-0806-05	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE (SDV,PF,LATEX-FREE) 50 MCG/1 ML	IJ
63323-0806-20	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE (SDV,PF,LATEX-FREE) 50 MCG/1 ML	IV
63323-0806-50	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	FENTANYL CITRATE (SDV,PF,LATEX-FREE) 50 MCG/1 ML	IV
63323-0808-11	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	SIMPLIST FENTANYL CITRATE (SD,PF) 50 MCG/1 ML	IJ
63323-0810-20	J3010	INJECTION, FENTANYL CITRATE, 0.1 MG	SIMPLIST FENTANYL CITRATE (SD,PF) 50 MCG/1 ML	IJ

HCPCS Code	Description	Billing Unit	SA Type
E0193 RR	Powered Air Flotation Bed (Low Air Loss Therapy)	Day	Y
E0194 RR	Air Fluidized Bed	Day	Y
E1399	Sterile Barrier Fields, Any Size	Each	Y
E1399	Sterile Q-Tips	Box of 100	Y
E1399	Sterile Specimen Cups	Each	Y
E1399	Steri-Strip Skin Closures	Env. (of 12)	Y
E1399	Suture Removal Tray	Each	Y
E1399	Twill Tape	Roll	Y
E0275	Bed Pan, Standard Metal Or Plastic	Each	N
E0275 RR	Bed Pan, Standard Metal Or Plastic	Day	N
E0276	Bed Pan Fracture Metal Or Plastic	Each	N
E0276 RR	Bed Pan Fracture Metal Or Plastic	Day	N