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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
63323-0738-20	J3490	UNCLASSIFIED DRUGS	FAMOTIDINE (M.D.V.) 10 MG/ML	IV
63323-0739-12	J3490	UNCLASSIFIED DRUGS	FAMOTIDINE (S.D.V.) 10 MG/ML	IV
63323-0750-10	J9263	INJECTION, OXALIPLATIN, 0.5 MG	OXALIPLATIN (SINGLE-USE VIAL; USP,PF) 5 MG/ML	IV
63323-0750-20	J9263	INJECTION, OXALIPLATIN, 0.5 MG	OXALIPLATIN (SINGLE-USE VIAL; USP,PF) 5 MG/1 ML	IV
63323-0751-01	J2370	INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML	PHENYLEPHRINE HCL (LATEX-FREE) 10 MG/1 ML	IV
63323-0751-01	J2371	INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS	PHENYLEPHRINE HCL (LATEX-FREE) 10 MG/1 ML	IV
63323-0751-05	J2370	INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML	PHENYLEPHRINE HCL (LATEX-FREE) 10 MG/1 ML	IV
63323-0751-05	J2371	INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS	PHENYLEPHRINE HCL (LATEX-FREE) 10 MG/1 ML	IV
63323-0751-10	J2370	INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML	PHENYLEPHRINE HCL (LATEX-FREE) 10 MG/1 ML	IV
63323-0751-10	J2371	INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS	PHENYLEPHRINE HCL (LATEX-FREE) 10 MG/1 ML	IV
63323-0751-13	J2370	INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML	PHENYLEPHRINE HCL NOVAPLUS 10 MG/1 ML	IV
65219-0564-20	J9280	INJECTION, MITOMYCIN, 5 MG	MITOMYCIN (PF,LATEX-FREE) 5 MG	IV

HCPCS Code	Description	Billing Unit	SA Type
A7009	Reservoir bottle, nondisoisable, used with large volume ultrasonic nebulizer	Each	N
A7010	Corrugated tubing, disposable, used with large volume nebulizer, 100 ft	100 Ft	N
A7012	Water collection device, used with large volume nebulizer	Each	N
A7013	Filter, disposable, used with aerosol compressor	Each	N
A7014	Filter, nondisposable, used with aerosol compressor or ultrasonic generator	Each	N
A7015	Aerosol mask, used with DME nebulizer	Each	N
A7016	Dome and mouthpiece, used with small volume ultrasonic nebulizer	Each	N
A7018	Water, distilled, used with large volume nebulizer, 1000 ml	Each	N
A7020	Interface for cough stimulating device, includes all components, replacement only	Each	Y
A7025	High Frequency chest wall oscillation system vest, replacement for with patient owned equipment, each	Each	Y
A7026	High Frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each	Each	Y
A7027	Combination oral/nasal mask, used with continious positive airway pressure device, each	Each	N