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NDC	HCPCS	HCPCS Description	NDC Label	Route of Administration
70700-0174-22	J9171	INJECTION, DOCETAXEL, 1 MG	DOCETAXEL (SD;USP,PF,LATEX-FREE) 10 MG/1 ML	IV
70700-0175-22	J9171	INJECTION, DOCETAXEL, 1 MG	DOCETAXEL (MDV;USP,PF,LATEX-FREE) 10 MG/1 ML	IV
70700-0176-22	J9171	INJECTION, DOCETAXEL, 1 MG	DOCETAXEL (MDV;USP,PF,LATEX-FREE) 10 MG/1 ML	IV
70700-0186-23	J9190	INJECTION, FLUOROURACIL, 500 MG	FLUOROURACIL (10X10ML;SD;USP,PF) 50 MG/1 ML	IV
70700-0187-23	J9190	INJECTION, FLUOROURACIL, 500 MG	FLUOROURACIL (10X20ML;SD;USP,PF) 50 MG/1 ML	IV
70700-0188-22	J9190	INJECTION, FLUOROURACIL, 500 MG	FLUOROURACIL (1X50ML;USP,PF) 50 MG/1 ML	IV
70700-0189-22	J9190	INJECTION, FLUOROURACIL, 500 MG	FLUOROURACIL (1X100ML;USP,PF) 50 MG/1 ML	IV
70700-0273-22	J1380	INJECTION, ESTRADIOL VALERATE, UP TO 10 MG	ESTRADIOL VALERATE (MDV,LATEX-FREE) 10 MG/1 ML	IM
70700-0286-22	J2675	INJECTION, PROGESTERONE, PER 50 MG	PROGESTERONE (MDV,LATEX-FREE) 50 MG/1 ML	IM
70700-0288-22	J1071	INJECTION, TESTOSTERONE CYPIONATE, 1 MG	TESTOSTERONE CYPIONATE (USP,MDV,LATEX-FREE) 100 MG/1 ML	IM
70700-0289-22	J1071	INJECTION, TESTOSTERONE CYPIONATE, 1 MG	TESTOSTERONE CYPIONATE (USP, SDV,LATEX-FREE) 200 MG/1 ML	IM
70700-0902-25	J7643	GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM	GLYCOPYRROLATE NOVAPLUS (25X5ML;MDV;USP) 0.2 MG/1 ML	IJ

HCPCS Code	Description	Billing Unit	SA Type
L2640	Addition to lower extremity, pelvic control, band and belt, bilateral	Each	Y
L2650	Addition to lower extremity, pelvic and thoracic control, gluteal pad , each	Each	Y
L2660	Addition to lower extremity, thoracic control, thoracic band	Each	Y
L2670	Addition to lower extremity, thoracic control, paraspinal uprights	Each	Y
L2680	Addition to lower extremity, thoracic control, lateral support uprights	Each	Y
L2750	Addition to lower extremity orthosis, plating chrome or nickel, per bar	Each	Y
L2755	Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only	Each	Y
L2760	Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)	Each	Y
L1945	AFO, molded to patient model, plastic, rigid anterior tibial section (floor reaction), custom fabricated	Each	Y
L1950	AFO, spiral, (Institute of Rehabilitative Medicine type), plastic, custom fabricated	Each	Y
L1951	AFO, spiral, (Institute of Rehabilitative Medicine type), plastic or other material, prefabricated, includes fitting and adjustment	Each	Y
L1960	AFO, posterior solid ankle, plastic, custom fabricated	Each	Y