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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
63323-0664-01	J1200	INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG	DIPHENHYDRAMINE HCL 50 MG/ML	IJ
63323-0665-01	J3105	INJECTION, TERBUTALINE SULFATE, UP TO 1 MG	TERBUTALINE SULFATE 1 MG/ML	SC
63323-0673-05	J2469	INJECTION, PALONOSETRON HCL, 25 MCG	PALONOSETRON HCL (SDV,LATEX-FREE) 0.05 MG/1 ML	IV
63323-0673-89	J2469	INJECTION, PALONOSETRON HCL, 25 MCG	SIMPLIST PALONOSETRON HCL 0.05 MG/1 ML	IV
63323-0690-30	J7608	ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM	ACETYLCYSTEINE (PDF) 20%	IH
63323-0690-30	J7608	ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM	ACETYLCYSTEINE (PDF) 20%	IH
67457-0546-20	J9027	INJECTION, CLOFARABINE, 1 MG	CLOFARABINE (PF) 1 MG/1 ML	IV
67457-0553-00	J3475	INJECTION, MAGNESIUM SULFATE, PER 500 MG	MAGNESIUM SULFATE (24X50ML;SINGLE DOSE) 40 MG/1 ML	IV
67457-0554-00	J3475	INJECTION, MAGNESIUM SULFATE, PER 500 MG	MAGNESIUM SULFATE (24X100ML;SINGLE DOSE) 40 MG/1 ML	IV
67457-0562-20	J0475	INJECTION, BACLOFEN, 10 MG	BACLOFEN (SDV) 0.5 MG/1 ML	IN
67457-0563-20	J0475	INJECTION, BACLOFEN, 10 MG	BACLOFEN (SDV) 1 MG/1 ML	IN
67457-0564-20	J0475	INJECTION, BACLOFEN, 10 MG	BACLOFEN (SDV) 1 MG/1 ML	IN

HCPCS Code	Description	Billing Unit	SA Type
A4605	Tracheal suction catheter, closed system, each	Each	N
A4606	Oxygen probe for use with oximeter device, replacement	Each	N
A4608	Transtracheal oxygen catheter, each	Each	Y
S8189	Tracheal suction catheter, closed system, for less than 72 hours of use	Each	Y
S8189	Tracheal suction catheter, closed system, for 72 hours or more of use (for Cath-n-sleeve use A4624)	Each	Y
A4614	Peak expiratory flow rate meter, hand held	Each	N
A4615	Cannula, nasal	Each	N
A4616	Tubing, oxygen	1 Feet	N
A4617	Mouth Piece	Each	N
A4618	Breathing circuits	Each	N
A4619	Face Tent	Each	N
A4620	Variable Concentration Mask	Each	N