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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
51927-2097-00	J0520	INJECTION, BETHANECHOL CHLORIDE, MYOTONACHOL OR URECHOLINE, UP TO 5 MG	BETHANECHOL CHLORIDE (U.S.P.)	NA
51927-2101-00	J0770	INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG	COLISTIMETHATE SODIUM (USP)	NA
51927-2118-00	J2360	INJECTION, ORPHENADRINE CITRATE, UP TO 60 MG	ORPHENADRINE CITRATE (USP)	NA
51927-2134-00	Q0164	PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN	PROCHLORPERAZINE MALEATE (U.S.P.)	NA
44087-9005-01	J3490	UNCLASSIFIED DRUGS	GONAL-F RFF 75 IU	SC
44087-9005-06	J3490	UNCLASSIFIED DRUGS	GONAL-F RFF 75 IU	SC
44087-9030-01	J3490	UNCLASSIFIED DRUGS	GONAL-F (M.D.V.) 450 IU	SC
44087-9070-01	J3490	UNCLASSIFIED DRUGS	GONAL-F (MDV) 1200 IU	SC
44206-0300-01	J2791	INJECTION, RHO(D) IMMUNE GLOBULIN (HUMAN), (RHOPHYLAC), INTRAMUSCULAR OR INTRAVENOUS, 100 IU	RHOPHYLAC (W/SAFETY NEEDLE) 750 IU/ML	IJ
44206-0300-10	J2791	INJECTION, RHO(D) IMMUNE GLOBULIN (HUMAN), (RHOPHYLAC), INTRAMUSCULAR OR INTRAVENOUS, 100 IU	RHOPHYLAC (W/SAFETY NEEDLE) 750 IU/ML	IJ
44206-0416-03	J1566	INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG	CARIMUNE NF (PF,NANOFILTERED) 3 GM	IV
44206-0417-06	J1566	INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG	CARIMUNE NF (PF,NANOFILTERED) 6 GM	IV

HCPCS Code	Description	Billing Unit	SA Type
A7005	Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable	Each	N
A7006	Administration set, with small volume filter pneumatic nebulizer	Each	N
A7007	Large voume nebulizer, disposable, unfilled, used with aerosol compressor	Each	N
A7008	Large volume nebulizer, disposable, Prefilled, used with aerosol compressor	Each	N