WELCOME

NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
70069-0301-10	J0330	INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG	SUCCINYLCHOLINE CHLORIDE (10X10ML;MDV) 20 MG/1 ML	IJ
70069-0301-25	J0330	INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG	SUCCINYLCHOLINE CHLORIDE 20 MG/1 ML	IJ
70069-0361-10	J3490	UNCLASSIFIED DRUGS	SULFAMETHOXAZOLE/TRIMETHOPRIM 80 MG/1 ML-16 MG/1 ML	IV
70069-0362-10	J3490	UNCLASSIFIED DRUGS	SULFAMETHOXAZOLE/TRIMETHOPRIM 80 MG/1 ML-16 MG/1 ML	IV
70069-0363-01	J3490	UNCLASSIFIED DRUGS	SULFAMETHOXAZOLE/TRIMETHOPRIM 80 MG/1 ML-16 MG/1 ML	IV
70069-0381-10	J1631	INJECTION, HALOPERIDOL DECANOATE, PER 50 MG	HALOPERIDOL DECANOATE (SDV) 50 MG/1 ML	IM
70069-0383-05	J1631	INJECTION, HALOPERIDOL DECANOATE, PER 50 MG	HALOPERIDOL DECANOATE (SDV) 100 MG/1 ML	IM
70069-0383-10	J1631	INJECTION, HALOPERIDOL DECANOATE, PER 50 MG	HALOPERIDOL DECANOATE (SDV) 100 MG/1 ML	IM
70069-0384-01	J1631	INJECTION, HALOPERIDOL DECANOATE, PER 50 MG	HALOPERIDOL DECANOATE (1X5ML;MDV) 100 MG/1 ML	IM
70069-0384-05	J1631	INJECTION, HALOPERIDOL DECANOATE, PER 50 MG	HALOPERIDOL DECANOATE (5X5ML;MDV) 100 MG/1 ML	IM
70069-0616-10	J7643	GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM	GLYCOPYRROLATE (10X20ML MDV) 0.2 MG/1 ML	IJ
70069-0616-10	J7643	GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM	GLYCOPYRROLATE (10X20ML MDV) 0.2 MG/1 ML	IJ

HCPCS Code	Description	Billing Unit	SA Type
L3808	Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment	Each	Y
L3809	Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type	Each	Y
L3206	Orhtopedic shoe, hightop with supinator or pronator, child	Each	Y
L3207	Orhtopedic shoe, hightop with supinator or pronator, junior	Each	Y
L3208	Surgical boot, each, infant	Each	Y
L3209	Surgical boot, each, child	Each	Y
L3211	Surgical boot, each, junior	Each	Y
L3212	Benesch boot, each, infant	Each	Y
L3213	Benesch boot, each, infant	Each	Y
L3214	Benesch boot, each, infant	Each	Y
L3215	Orthopedic footwear, ladies shoe, oxford, each	Each	Y
L3216	Orthopedic footwear, ladies shoe, depth inlay, each	Each	Y