266
1.1.2015 HCPCS_CODE NATIONAL_DRUG_CODE HCFA TERM DATE OBSOLETE DATE A4216 00074210230 12/31/2999 7/19/2011 A4216 00264180031 12/31/2999 12/31/2999 A4216 00264180036 12/31/2999 12/31/2999 A4216 00338004910 12/31/2999 12/31/2999 A4216 00338004911 12/31/2999 12/31/2999 A4216 00338004931 12/31/2999 12/31/2999 A4216 00338004941 12/31/2999 12/31/2999 A4216 00338055311 12/31/2999 12/31/2999 A4216 00378699789 12/31/2999 12/31/2999 A4216 00409108151 12/31/2999 12/31/2999 A4216 00409191832 12/31/2999 12/31/2999 A4216 00409191833 12/31/2999 12/31/2999 A4216 00409191835 12/31/2999 12/31/2999 A4216 00409196605 12/31/2999 12/31/2999 A4216 00409196607 12/31/2999 12/31/2999 A4216 00409196612 12/31/2999 12/31/2999 A4216 00409210202 12/31/2999 12/31/2999 A4216 00409210205 12/31/2999 12/31/2999 A4216 00409397703 12/31/2999 12/31/2999 A4216 00409402903 12/31/2999 12/31/2999 A4216 00409488710 12/31/2999 12/31/2999 A4216 00409488720 12/31/2999 12/31/2999 A4216 00409488750 12/31/2999 12/31/2999 A4216 00409488799 12/31/2999 12/31/2999 A4216 00409488810 12/31/2999 12/31/2999 A4216 00409488812 12/31/2999 12/31/2999 A4216 00409488820 12/31/2999 12/31/2999 A4216 00409488850 12/31/2999 12/31/2999 A4216 00409710166 12/31/2999 12/31/2999 A4216 00409798406 12/31/2999 12/31/2999 A4216 00409798411 12/31/2999 12/31/2999 A4216 00409798413 12/31/2999 12/31/2999 *This document is a compilation of NDC:HCPCS combinations derived from the quarterly ASP Pricing files publicly available from the CMS website (www.cms.gov). *This spreadsheet does NOT limit NDC:HCPCS combinations based on the CMS rebate status of the NDC. Please refer to the most current guide available on www.cms.gov *Providers remain responsible for ensuring the accuracy of their claim processing edits for purposes of capturing NDCs for physician administered drugs submitted on institutional and/or professional claim.

*This document is a compilation of NDC:HCPCS combinations

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Page 1: *This document is a compilation of NDC:HCPCS combinations

1.1.2015

HCPCS_CODE NATIONAL_DRUG_CODE HCFA TERM DATE OBSOLETE DATEA4216 00074210230 12/31/2999 7/19/2011A4216 00264180031 12/31/2999 12/31/2999A4216 00264180036 12/31/2999 12/31/2999A4216 00338004910 12/31/2999 12/31/2999A4216 00338004911 12/31/2999 12/31/2999A4216 00338004931 12/31/2999 12/31/2999A4216 00338004941 12/31/2999 12/31/2999A4216 00338055311 12/31/2999 12/31/2999A4216 00378699789 12/31/2999 12/31/2999A4216 00409108151 12/31/2999 12/31/2999A4216 00409191832 12/31/2999 12/31/2999A4216 00409191833 12/31/2999 12/31/2999A4216 00409191835 12/31/2999 12/31/2999A4216 00409196605 12/31/2999 12/31/2999A4216 00409196607 12/31/2999 12/31/2999A4216 00409196612 12/31/2999 12/31/2999A4216 00409210202 12/31/2999 12/31/2999A4216 00409210205 12/31/2999 12/31/2999A4216 00409397703 12/31/2999 12/31/2999A4216 00409402903 12/31/2999 12/31/2999A4216 00409488710 12/31/2999 12/31/2999A4216 00409488720 12/31/2999 12/31/2999A4216 00409488750 12/31/2999 12/31/2999A4216 00409488799 12/31/2999 12/31/2999A4216 00409488810 12/31/2999 12/31/2999A4216 00409488812 12/31/2999 12/31/2999A4216 00409488820 12/31/2999 12/31/2999A4216 00409488850 12/31/2999 12/31/2999A4216 00409710166 12/31/2999 12/31/2999A4216 00409798406 12/31/2999 12/31/2999A4216 00409798411 12/31/2999 12/31/2999A4216 00409798413 12/31/2999 12/31/2999

*This document is a compilation of NDC:HCPCS combinations derived from the quarterly ASP Pricing files publicly available from the CMS website (www.cms.gov). *This spreadsheet does

NOT limit NDC:HCPCS combinations based on the CMS rebate status of the NDC. Please refer to the most current guide available on www.cms.gov *Providers remain responsible for ensuring

the accuracy of their claim processing edits for purposes of capturing NDCs for physician administered drugs submitted on institutional and/or professional claim.

Page 2: *This document is a compilation of NDC:HCPCS combinations

A4216 00409798420 12/31/2999 12/31/2999A4216 00409798436 12/31/2999 12/31/2999A4216 00487930102 12/31/2999 12/31/2999A4216 00487930103 12/31/2999 12/31/2999A4216 00487930133 12/31/2999 12/31/2999A4216 00517066225 12/31/2999 12/1/2011A4216 00517281025 12/31/2999 12/31/2999A4216 00517300525 12/31/2999 12/31/2999A4216 00517301025 12/31/2999 12/31/2999A4216 00517302025 12/31/2999 12/31/2999A4216 00517305025 9/30/2014 12/1/2011A4216 08290031002 12/31/2999 12/31/2999A4216 08290031003 12/31/2999 12/31/2999A4216 08290031102 12/31/2999 12/31/2999A4216 08290031103 12/31/2999 12/31/2999A4216 08290032003 12/31/2999 12/31/2999A4216 08290032005 12/31/2999 12/31/2999A4216 08290032103 12/31/2999 12/31/2999A4216 08290032105 12/31/2999 12/31/2999A4216 08290033003 12/31/2999 12/31/2999A4216 08290033005 12/31/2999 12/31/2999A4216 08290033006 12/31/2999 12/31/2999A4216 08290033010 12/31/2999 12/31/2999A4216 08290033103 12/31/2999 12/31/2999A4216 08290033105 12/31/2999 12/31/2999A4216 08290033110 12/31/2999 12/31/2999A4216 08290091002 12/31/2999 12/31/2999A4216 08290091102 12/31/2999 12/31/2999A4216 08290091103 12/31/2999 12/31/2999A4216 08290092105 12/31/2999 12/31/2999A4216 08290093010 12/31/2999 12/31/2999A4216 08290094110 12/31/2999 12/31/2999A4216 08881570121 12/31/2999 12/31/2999A4216 08881570123 12/31/2999 12/31/2999A4216 08881570125 12/31/2999 12/31/2999A4216 08881570128 12/31/2999 12/31/2999A4216 08881570129 12/31/2999 12/31/2999A4216 08881570300 12/31/2999 12/31/2999A4216 08881571121 12/31/2999 12/31/2999A4216 08881571123 12/31/2999 12/31/2999A4216 08881571125 12/31/2999 12/31/2999A4216 08881571300 12/31/2999 12/31/2999A4216 49502064015 12/31/2999 6/30/2012A4216 54868018300 12/31/2999 6/30/2012A4216 54868252700 12/31/2999 6/30/2008A4216 54868343300 12/31/2999 6/30/2012A4216 54868446400 12/31/2999 6/30/2012

Page 3: *This document is a compilation of NDC:HCPCS combinations

A4216 54868571400 12/31/2999 6/30/2011A4216 58016499501 12/31/2999 11/29/2012A4216 58016946401 12/31/2999 11/29/2012A4216 63323018500 12/31/2999 12/31/2999A4216 63323018505 12/31/2999 12/31/2999A4216 63323018510 12/31/2999 12/31/2999A4216 63323018520 12/31/2999 12/31/2999A4216 63323018550 12/31/2999 12/31/2999A4216 63323018602 12/31/2999 12/31/2999A4216 63323018610 12/31/2999 12/31/2999A4216 63323018620 12/31/2999 12/31/2999A4216 63323024930 12/31/2999 12/31/2999A4216 63323025930 12/31/2999 12/31/2999A4216 63323092410 12/31/2999 12/31/2999A4216 63323092430 12/31/2999 12/31/2999A4216 63807010001 12/31/2999 12/31/2999A4216 63807010003 12/31/2999 12/31/2999A4216 63807010005 12/31/2999 12/31/2999A4216 63807010010 12/31/2999 12/31/2999A4216 63807010011 12/31/2999 12/31/2999A4216 63807010030 12/31/2999 12/31/2999A4216 63807010033 12/31/2999 12/31/2999A4216 63807010035 12/31/2999 12/31/2999A4216 63807010050 12/31/2999 5/2/2011A4216 63807010051 12/31/2999 12/31/2999A4216 63807010055 12/31/2999 12/31/2999A4216 63807010075 12/31/2999 12/31/2999A4216 63807010512 12/31/2999 1/1/2009A4216 63807011012 12/31/2999 1/1/2009A4216 63807013012 12/31/2999 1/1/2009A4216 63807016011 12/31/2999 2/1/2013A4216 63807016031 12/31/2999 2/1/2013A4216 63807016051 12/31/2999 2/1/2013A4216 64253011121 12/31/2999 12/31/2999A4216 64253011122 12/31/2999 12/31/2999A4216 64253011123 12/31/2999 12/31/2999A4216 64253011125 12/31/2999 12/31/2999A4216 64253011130 12/31/2999 12/31/2999A4216 64253011133 12/31/2999 12/31/2999A4216 64253011135 12/31/2999 12/31/2999A4216 68883060005 12/31/2999 12/31/2999A4216 68883060010 12/31/2999 12/31/2999A4216 68883060016 12/31/2999 8/1/2011A4216 68883090001 12/31/2999 1/2/2013A4216 68883090003 12/31/2999 1/2/2013A4216 68883090004 12/31/2999 1/2/2013A4217 00264210100 12/31/2999 12/31/2999

Page 4: *This document is a compilation of NDC:HCPCS combinations

A4217 00264210110 12/31/2999 12/31/2999A4217 00264210150 12/31/2999 12/31/2999A4217 00264210170 12/31/2999 12/31/2999A4217 00264220100 12/31/2999 12/31/2999A4217 00264220110 12/31/2999 12/31/2999A4217 00264220150 12/31/2999 12/31/2999A4217 00264220170 12/31/2999 12/31/2999A4217 00264785000 12/31/2999 12/31/2999A4217 00264785010 12/31/2999 12/31/2999A4217 00264785020 12/31/2999 12/31/2999A4217 00264920055 8/31/2013 12/31/2999A4217 00264920155 9/30/2013 12/31/2999A4217 00338000344 12/31/2999 12/31/2999A4217 00338000346 12/31/2999 12/31/2999A4217 00338000347 12/31/2999 12/31/2999A4217 00338000402 12/31/2999 12/31/2999A4217 00338000403 12/31/2999 12/31/2999A4217 00338000404 12/31/2999 12/31/2999A4217 00338000405 12/31/2999 12/31/2999A4217 00338001304 12/31/2999 12/31/2999A4217 00338001306 12/31/2999 12/31/2999A4217 00338001308 12/31/2999 12/31/2999A4217 00338001329 12/31/2999 12/31/2999A4217 00338004727 12/31/2999 12/31/2999A4217 00338004729 12/31/2999 12/31/2999A4217 00338004744 12/31/2999 12/31/2999A4217 00338004746 12/31/2999 12/31/2999A4217 00338004747 12/31/2999 12/31/2999A4217 00338004802 12/31/2999 12/31/2999A4217 00338004803 12/31/2999 12/31/2999A4217 00338004804 12/31/2999 12/31/2999A4217 00338004805 12/31/2999 12/31/2999A4217 00338005047 12/31/2999 12/31/2999A4217 00338005144 12/31/2999 12/31/2999A4217 00409159002 12/31/2999 12/31/2999A4217 00409613803 12/31/2999 12/31/2999A4217 00409613822 12/31/2999 12/31/2999A4217 00409613903 12/31/2999 12/31/2999A4217 00409613922 12/31/2999 12/31/2999A4217 00409711807 12/31/2999 12/31/2999A4217 00409713809 12/31/2999 12/31/2999A4217 00409713836 12/31/2999 12/31/2999A4217 00409713909 12/31/2999 12/31/2999A4217 00409713936 12/31/2999 12/31/2999A4217 00409797205 12/31/2999 12/31/2999A4217 00409797207 12/31/2999 12/31/2999A4217 00409797208 12/31/2999 12/31/2999

Page 5: *This document is a compilation of NDC:HCPCS combinations

A4217 00409797305 12/31/2999 12/31/2999A4217 00409797307 12/31/2999 12/31/2999A4217 00409797308 12/31/2999 12/31/2999A4217 00409799009 12/31/2999 12/31/2999A4217 08080100000 12/31/2999 12/31/2999A4217 08080102000 12/31/2999 12/31/2999A4217 11701015935 12/31/2999 12/31/2999A4217 11701015936 12/31/2999 12/31/2999A4217 54868071000 12/31/2999 3/31/2011A4217 54868071001 12/31/2999 3/31/2011A4217 54868071002 12/31/2999 5/30/2012A4269 48723000111 12/31/2999 12/31/2999A4269 48723000333 12/31/2999 9/1/2012A4269 48723000666 12/31/2999 12/31/2999A4269 48723000999 12/31/2999 12/31/2999A4269 48723082891 12/31/2999 12/31/2999A4269 52925011201 12/31/2999 12/31/2999A4269 52925011202 12/31/2999 12/31/2999A4269 52925011203 12/31/2999 9/1/2012A4269 52925011204 12/31/2999 12/31/2999A4269 52925031214 12/31/2999 12/31/2999A9543 68152010303 12/31/2999 12/31/2999A9544 00007326101 12/31/2999 12/31/2999A9545 00007326201 12/31/2999 12/31/2999A9575 67684200001 12/31/2999 12/31/2999A9575 67684200002 12/31/2999 12/31/2999A9575 67684200003 12/31/2999 12/31/2999A9575 67684200004 12/31/2999 12/31/2999A9575 67684200005 12/31/2999 12/31/2999A9575 67684200006 12/31/2999 12/31/2999A9575 67684200007 12/31/2999 12/31/2999A9576 00270111170 12/31/2999 12/31/2999A9577 00270516412 12/31/2999 12/31/2999A9577 00270516413 12/31/2999 12/31/2999A9577 00270516414 12/31/2999 12/31/2999A9577 00270516415 12/31/2999 12/31/2999A9578 00270526416 12/31/2999 12/31/2999A9578 00270526417 12/31/2999 12/31/2999A9579 00019117702 12/31/2999 12/31/2999A9579 00019117704 12/31/2999 12/31/2999A9579 00019117706 12/31/2999 12/31/2999A9579 00019117708 12/31/2999 12/31/2999A9579 00019117710 12/31/2999 12/31/2999A9579 00019117715 12/31/2999 12/31/2999A9579 00019117716 12/31/2999 12/31/2999A9579 00019117720 12/31/2999 12/31/2999A9579 00019117721 12/31/2999 12/31/2999

Page 6: *This document is a compilation of NDC:HCPCS combinations

A9579 00019117730 12/31/2999 12/31/2999A9579 00019117731 12/31/2999 12/31/2999A9579 00019117750 12/31/2999 12/31/2999A9579 00270111101 12/31/2999 12/31/2999A9579 00270111102 12/31/2999 12/31/2999A9579 00270111103 12/31/2999 12/31/2999A9579 00270111104 12/31/2999 12/31/2999A9579 00270111116 12/31/2999 12/31/2999A9579 00270111145 12/31/2999 12/31/2999A9579 00407069005 12/31/2999 12/31/2999A9579 00407069010 12/31/2999 12/31/2999A9579 00407069012 12/31/2999 12/31/2999A9579 00407069015 12/31/2999 12/31/2999A9579 00407069017 12/31/2999 12/31/2999A9579 00407069020 12/31/2999 12/31/2999A9579 00407069022 12/31/2999 12/31/2999A9579 00407069030 12/31/2999 12/31/2999A9579 00407069040 12/31/2999 12/31/2999A9579 00407069042 12/31/2999 12/31/2999A9579 00407069043 12/31/2999 12/31/2999A9579 00407069050 12/31/2999 12/31/2999A9579 00407069070 12/31/2999 12/31/2012A9579 00407069162 12/31/2999 12/31/2999A9579 00407069163 12/31/2999 12/31/2999A9579 50419018801 12/31/2999 12/31/2999A9579 50419018802 12/31/2999 12/31/2999A9579 50419018805 12/31/2999 12/31/2999A9579 50419018810 12/31/2999 12/1/2006A9579 50419018811 12/31/2999 12/31/2999A9579 50419018815 12/31/2999 12/31/2999A9579 50419018836 12/31/2999 12/31/2999A9579 50419018837 12/31/2999 12/31/2999A9579 50419018838 12/31/2999 12/31/2999A9579 50419018844 12/31/2999 12/31/2999A9579 50419018847 12/31/2999 12/31/2999A9579 50419018858 12/31/2999 12/31/2999A9581 50419032005 12/31/2999 12/31/2999A9581 50419032015 12/31/2999 12/31/2999A9582 17156023501 12/31/2999 12/31/2999A9583 11994001201 12/31/2999 12/31/2999A9583 11994001202 12/31/2999 12/31/2999A9584 17156021001 12/31/2999 12/31/2999A9585 50419032511 12/31/2999 12/31/2999A9585 50419032512 12/31/2999 12/31/2999A9585 50419032513 12/31/2999 12/31/2999A9585 50419032514 12/31/2999 12/31/2999A9585 50419032515 12/31/2999 12/31/2999

Page 7: *This document is a compilation of NDC:HCPCS combinations

A9585 50419032527 12/31/2999 12/31/2999A9585 50419032528 12/31/2999 12/31/2999A9585 50419032529 12/31/2999 12/31/2999A9600 17156052401 12/31/2999 12/31/2999A9604 57902086001 12/31/2999 12/31/2999C9021 50242007001 12/31/2999 12/31/2999C9113 00008092351 12/31/2999 12/31/2999C9113 00008092355 12/31/2999 12/31/2999C9121 00007440701 12/31/2999 12/31/2999C9121 00007440754 12/31/2999 12/31/2999C9121 00143967401 12/31/2999 12/31/2999C9121 00781328512 12/31/2999 12/31/2999C9121 00781331495 12/31/2999 12/31/2999C9121 00781931495 12/31/2999 12/31/2999C9121 42367020284 12/31/2999 12/31/2999C9130 59730650201 12/31/2999 12/31/2999C9130 59730650301 12/31/2999 12/31/2999C9131 50242008701 12/31/2999 12/31/2999C9131 50242008801 12/31/2999 12/31/2999C9132 63833038602 12/31/2999 12/31/2999C9133 00944302602 12/31/2999 12/31/2999C9133 00944302802 12/31/2999 12/31/2999C9133 00944303002 12/31/2999 12/31/2999C9133 00944303202 12/31/2999 12/31/2999C9133 00944303402 12/31/2999 12/31/2999C9248 65293000200 12/31/2999 10/3/2011C9248 65293000250 12/31/2999 10/3/2011C9248 65293000500 12/31/2999 12/31/2999C9248 65293000511 12/31/2999 12/31/2999C9248 65293000550 12/31/2999 12/31/2999C9248 65293000555 12/31/2999 12/31/2999C9250 00944435108 12/31/2999 2/22/2011C9250 00944435112 12/31/2999 2/22/2011C9250 00944850302 12/31/2999 12/31/2999C9250 00944850304 12/31/2999 12/31/2999C9250 00944850310 12/31/2999 12/31/2999C9254 00131181067 12/31/2999 12/31/2999C9257 50242006001 12/31/2999 12/31/2999C9257 50242006101 12/31/2999 12/31/2999C9270 64208823401 12/31/2999 12/31/2999C9270 64208823402 12/31/2999 12/31/2999C9270 64208823403 12/31/2999 12/31/2999C9272 55513071001 12/31/2999 12/31/2999C9272 55513073001 12/31/2999 12/31/2999C9274 00281033010 6/30/2013 10/1/2010C9274 50633011012 12/31/2999 12/31/2999C9275 00407408601 12/31/2999 12/31/2012

Page 8: *This document is a compilation of NDC:HCPCS combinations

C9276 00024582411 12/31/2999 12/31/2999C9277 58468016001 12/31/2999 12/31/2999C9279 66220024704 12/31/2999 12/31/2999C9279 66220028708 12/31/2999 12/31/2999C9280 62856038901 12/31/2999 12/31/2999C9281 54396080101 12/31/2999 12/31/2999C9282 00456040001 12/31/2999 12/31/2999C9282 00456040010 12/31/2999 12/31/2999C9282 00456060001 12/31/2999 12/31/2999C9282 00456060010 12/31/2999 12/31/2999C9283 43825010201 12/31/2999 12/31/2999C9284 00003232711 12/31/2999 12/31/2999C9284 00003232822 12/31/2999 12/31/2999C9285 43469086401 12/31/2999 12/31/2999C9285 43469086410 12/31/2999 12/31/2999C9286 00003037113 12/31/2999 12/31/2999C9287 51144005001 12/31/2999 12/31/2999C9288 66621015001 12/31/2999 12/31/2999C9289 57902024905 12/31/2999 12/31/2999C9290 65250026620 12/31/2999 12/31/2999C9292 50242014501 12/31/2999 12/31/2999C9293 50633021011 12/31/2999 12/31/2999C9294 00069010601 12/31/2999 12/31/2999C9295 76075010101 12/31/2999 12/31/2999C9296 00024584001 12/31/2999 12/31/2999C9296 00024584101 12/31/2999 12/31/2999C9297 63459017714 12/31/2999 12/31/2999C9298 24856000100 12/31/2999 12/31/2999C9365 08213000009 12/31/2999 12/31/2999C9365 08213000011 12/31/2999 12/31/2999C9367 21902012900 12/31/2999 12/31/2999C9367 21902012901 12/31/2999 12/31/2999C9367 21902012902 12/31/2999 12/31/2999C9367 21902012903 12/31/2999 12/31/2999C9367 21902012904 12/31/2999 12/31/2999C9367 21902012905 12/31/2999 12/31/2999C9399 00002759701 12/31/2999 12/31/2999C9399 00002763511 12/31/2999 12/31/2999C9399 00002763611 12/31/2999 12/31/2999C9399 00002763711 12/31/2999 12/31/2999C9399 00003223011 12/31/2999 12/31/2999C9399 00003224011 12/31/2999 12/31/2999C9399 00003256016 12/31/2999 12/31/2999C9399 00003257016 12/31/2999 12/31/2999C9399 00004035009 12/31/2999 12/31/2999C9399 00004691106 1/31/2013 1/31/2013C9399 00008092351 12/31/2999 12/31/2999

Page 9: *This document is a compilation of NDC:HCPCS combinations

C9399 00008092355 12/31/2999 12/31/2999C9399 00008117901 12/31/2999 12/31/2999C9399 00008117905 12/31/2999 12/31/2999C9399 00009023301 12/31/2999 12/31/2999C9399 00009023344 4/1/2013 1/1/2011C9399 00009043624 12/31/2999 2/26/2013C9399 00009072809 12/31/2999 12/31/2999C9399 00009077526 12/31/2999 12/31/2999C9399 00009087026 12/31/2999 12/31/2999C9399 00009090211 12/31/2999 12/31/2999C9399 00009090218 12/31/2999 12/31/2999C9399 00009312403 12/31/2999 12/31/2999C9399 00009337502 12/31/2999 12/31/2999C9399 00009338102 12/31/2999 12/31/2999C9399 00009338201 12/31/2999 12/31/2999C9399 00009338202 12/31/2999 12/31/2999C9399 00009344703 12/31/2999 12/31/2999C9399 00015191012 12/31/2999 12/31/2999C9399 00015191113 12/31/2999 12/31/2999C9399 00023334807 12/31/2999 12/31/2999C9399 00024582411 12/31/2999 12/31/2999C9399 00024584001 12/31/2999 12/31/2999C9399 00024584101 12/31/2999 12/31/2999C9399 00029657126 12/31/2999 12/31/2999C9399 00029657131 12/31/2999 12/31/2999C9399 00029657921 12/31/2999 12/31/2999C9399 00065054301 12/31/2999 12/31/2999C9399 00068059701 12/31/2999 12/31/2999C9399 00069000601 12/31/2999 12/31/2999C9399 00069000603 12/31/2999 12/31/2999C9399 00069009303 12/31/2999 12/31/2999C9399 00069009402 12/31/2999 12/31/2999C9399 00069010404 12/31/2999 12/31/2999C9399 00069010503 12/31/2999 12/31/2999C9399 00069010601 12/31/2999 12/31/2999C9399 00069010805 12/31/2999 12/31/2999C9399 00069011201 12/31/2999 12/31/2999C9399 00069012102 12/31/2999 12/31/2999C9399 00069012502 12/31/2999 12/31/2999C9399 00069012602 12/31/2999 12/31/2999C9399 00069014101 12/31/2999 1/30/2013C9399 00074114315 12/31/2999 7/19/2011C9399 00074156410 12/31/2999 12/31/2999C9399 00074229111 12/31/2999 5/2/2011C9399 00074400001 12/31/2999 7/19/2011C9399 00078040001 12/31/2999 12/31/2999C9399 00078041420 12/31/2999 12/31/2999

Page 10: *This document is a compilation of NDC:HCPCS combinations

C9399 00078041520 12/31/2999 12/31/2999C9399 00078041720 12/31/2999 12/31/2999C9399 00078058261 12/31/2999 12/31/2999C9399 00143966010 12/31/2999 12/31/2999C9399 00143967910 12/31/2999 12/31/2999C9399 00143968025 12/31/2999 12/31/2999C9399 00143968125 12/31/2999 12/31/2999C9399 00143968225 12/31/2999 12/31/2999C9399 00143968310 12/31/2999 12/31/2999C9399 00143968410 12/31/2999 12/31/2999C9399 00143977226 12/31/2999 5/13/2011C9399 00143978310 12/31/2999 12/31/2999C9399 00143978410 12/31/2999 12/31/2999C9399 00143978610 12/31/2999 12/31/2999C9399 00143978710 12/31/2999 12/31/2999C9399 00143987310 12/31/2999 12/31/2999C9399 00186015501 5/31/2013 7/13/2010C9399 00186024444 12/31/2999 2/1/2013C9399 00186103001 4/30/2013 8/4/2009C9399 00186103101 4/30/2013 11/5/2009C9399 00186103301 5/31/2013 9/16/2009C9399 00186103312 4/30/2013 1/4/2010C9399 00186103501 5/31/2013 9/1/2009C9399 00186103712 12/31/2999 8/4/2009C9399 00186602001 12/31/2999 12/31/2999C9399 00186604001 12/31/2999 12/31/2999C9399 00264553532 12/31/2999 12/31/2999C9399 00264762500 12/31/2999 12/31/2999C9399 00264780510 12/31/2999 12/31/2999C9399 00264780610 12/31/2999 12/31/2999C9399 00310030065 12/31/2999 3/17/2008C9399 00338005403 12/31/2999 12/31/2999C9399 00338005603 12/31/2999 12/31/2999C9399 00338101741 12/31/2999 12/31/2999C9399 00338101948 12/31/2999 12/31/2999C9399 00338104702 12/31/2999 12/31/2999C9399 00338104902 12/31/2999 12/31/2999C9399 00338105102 12/31/2999 12/31/2999C9399 00338105548 12/31/2999 12/31/2999C9399 00338519741 12/31/2999 12/31/2999C9399 00338519841 12/31/2999 10/18/2008C9399 00378699152 12/31/2999 12/31/2999C9399 00378699252 12/31/2999 12/31/2999C9399 00407408601 12/31/2999 12/31/2012C9399 00409114402 12/31/2999 12/31/2999C9399 00409115801 12/31/2999 12/31/2999C9399 00409115901 12/31/2999 12/31/2999

Page 11: *This document is a compilation of NDC:HCPCS combinations

C9399 00409115902 12/31/2999 12/31/2999C9399 00409116001 12/31/2999 12/31/2999C9399 00409116101 12/31/2999 12/31/2999C9399 00409116201 12/31/2999 12/31/2999C9399 00409116202 12/31/2999 12/31/2999C9399 00409116301 12/31/2999 12/31/2999C9399 00409116401 12/31/2999 12/31/2999C9399 00409116501 12/31/2999 12/31/2999C9399 00409116502 12/31/2999 12/31/2999C9399 00409117101 12/31/2999 12/31/2999C9399 00409117102 12/31/2999 12/31/2999C9399 00409132305 12/31/2999 12/31/2999C9399 00409141204 12/31/2999 12/31/2999C9399 00409141210 12/31/2999 12/31/2999C9399 00409141249 12/31/2999 12/31/2999C9399 00409141250 12/31/2999 12/31/2999C9399 00409148202 12/31/2999 12/31/2999C9399 00409148302 12/31/2999 12/31/2999C9399 00409148303 12/31/2999 12/31/2999C9399 00409148402 12/31/2999 12/31/2999C9399 00409148403 12/31/2999 12/31/2999C9399 00409155910 12/31/2999 12/31/2999C9399 00409155930 12/31/2999 12/31/2999C9399 00409156010 12/31/2999 12/31/2999C9399 00409156029 12/31/2999 12/31/2999C9399 00409158210 12/31/2999 12/31/2999C9399 00409158229 12/31/2999 12/31/2999C9399 00409158603 12/31/2999 12/31/2999C9399 00409158750 12/31/2999 12/31/2999C9399 00409161050 12/31/2999 12/31/2999C9399 00409163110 12/31/2999 12/31/2999C9399 00409163201 12/31/2999 12/31/2999C9399 00409163249 12/31/2999 12/31/2999C9399 00409163401 12/31/2999 12/31/2999C9399 00409177805 12/31/2999 12/31/2999C9399 00409177835 12/31/2999 12/31/2999C9399 00409205105 12/31/2999 12/31/2999C9399 00409205310 12/31/2999 12/31/2999C9399 00409206605 12/31/2999 12/31/2999C9399 00409212201 12/31/2999 12/31/2999C9399 00409212202 12/31/2999 12/31/2999C9399 00409212213 12/31/2999 12/31/2999C9399 00409212288 12/31/2999 12/31/2999C9399 00409226602 12/31/2999 12/31/2999C9399 00409226605 12/31/2999 12/31/2999C9399 00409226649 12/31/2999 12/31/2999C9399 00409226651 12/31/2999 12/31/2999

Page 12: *This document is a compilation of NDC:HCPCS combinations

C9399 00409226720 12/31/2999 12/31/2999C9399 00409226754 12/31/2999 12/31/2999C9399 00409228505 12/31/2999 12/31/2999C9399 00409233934 12/31/2999 12/31/2999C9399 00409329451 12/31/2999 12/31/2999C9399 00409329905 12/31/2999 12/31/2999C9399 00409329906 12/31/2999 12/31/2999C9399 00409401101 12/31/2999 12/31/2999C9399 00409405001 12/31/2999 12/31/2999C9399 00409405101 12/31/2999 12/31/2999C9399 00409405201 12/31/2999 12/31/2999C9399 00409405303 12/31/2999 12/31/2999C9399 00409405403 12/31/2999 12/31/2999C9399 00409405503 12/31/2999 12/31/2999C9399 00409405601 12/31/2999 12/31/2999C9399 00409419701 12/31/2999 12/31/2999C9399 00409427201 12/31/2999 12/31/2999C9399 00409427301 12/31/2999 12/31/2999C9399 00409427501 6/1/2013 6/1/2013C9399 00409427601 12/31/2999 12/31/2999C9399 00409427602 12/31/2999 12/31/2999C9399 00409427701 12/31/2999 12/31/2999C9399 00409427702 12/31/2999 12/31/2999C9399 00409427801 12/31/2999 12/31/2999C9399 00409428201 12/31/2999 12/31/2999C9399 00409428202 12/31/2999 12/31/2999C9399 00409428301 12/31/2999 12/31/2999C9399 00409434673 12/31/2999 12/31/2999C9399 00409435003 12/31/2999 12/31/2999C9399 00409469924 12/31/2999 12/31/2999C9399 00409469930 12/31/2999 12/31/2999C9399 00409469933 12/31/2999 12/31/2999C9399 00409469962 12/31/2999 12/31/2999C9399 00409477601 12/31/2999 12/31/2999C9399 00409490034 12/31/2999 12/31/2999C9399 00409490334 12/31/2999 12/31/2999C9399 00409491634 12/31/2999 12/31/2999C9399 00409492834 12/31/2999 12/31/2999C9399 00409553434 12/31/2999 12/31/2999C9399 00409562201 12/31/2999 12/31/2999C9399 00409575701 12/31/2999 12/31/2999C9399 00409660902 12/31/2999 12/31/2999C9399 00409662502 12/31/2999 12/31/2999C9399 00409663734 12/31/2999 12/31/2999C9399 00409669501 12/31/2999 12/31/2999C9399 00409669502 12/31/2999 12/31/2999C9399 00409711609 12/31/2999 12/31/2999

Page 13: *This document is a compilation of NDC:HCPCS combinations

C9399 00409729501 12/31/2999 5/1/2012C9399 00409729973 12/31/2999 12/31/2999C9399 00409744401 12/31/2999 12/31/2999C9399 00409744501 12/31/2999 12/31/2999C9399 00409781124 12/31/2999 12/31/2999C9399 00409781137 12/31/2999 12/31/2999C9399 00409790509 12/31/2999 12/31/2999C9399 00409806029 12/31/2999 12/31/2999C9399 00409806101 12/31/2999 12/31/2999C9399 00409806201 12/31/2999 12/31/2999C9399 00409818301 12/31/2999 12/31/2999C9399 00409963305 12/31/2999 12/31/2999C9399 00469352530 12/31/2999 12/31/2999C9399 00469357550 12/31/2999 12/31/2999C9399 00469650189 12/31/2999 12/31/2999C9399 00517041010 12/31/2999 12/31/2999C9399 00517051025 12/31/2999 12/31/2999C9399 00517078010 12/31/2999 12/31/2999C9399 00517078110 12/31/2999 12/31/2999C9399 00517101905 10/31/2012 12/31/2999C9399 00517102025 12/31/2999 12/31/2999C9399 00517135501 12/31/2999 12/31/2999C9399 00517135525 12/31/2999 12/31/2999C9399 00517205325 12/31/2999 12/31/2999C9399 00517209625 12/31/2999 12/31/2999C9399 00517230525 12/31/2999 12/31/2999C9399 00517231525 12/31/2999 12/31/2999C9399 00517235025 12/31/2999 12/31/2999C9399 00517271025 12/31/2999 12/31/2999C9399 00517306501 12/31/2999 12/31/2999C9399 00517460125 12/31/2999 12/31/2999C9399 00517460225 12/31/2999 12/31/2999C9399 00517460525 12/31/2999 12/31/2999C9399 00517462025 12/31/2999 12/31/2999C9399 00517481025 12/31/2999 12/31/2999C9399 00517501901 8/31/2013 12/31/2999C9399 00517502325 12/31/2999 12/31/2999C9399 00517502425 12/31/2999 12/31/2999C9399 00517505001 12/31/2999 12/31/2999C9399 00517621025 12/31/2999 12/31/2999C9399 00517912025 12/31/2999 12/31/2999C9399 00548330400 10/31/2014 1/25/2013C9399 00548335200 10/31/2014 11/28/2012C9399 00548339000 9/30/2014 11/20/2012C9399 00548824100 12/31/2999 4/1/2004C9399 00548824200 12/31/2999 4/1/2004C9399 00548824300 12/31/2999 4/1/2004

Page 14: *This document is a compilation of NDC:HCPCS combinations

C9399 00591346853 12/31/2999 12/31/2999C9399 00641276443 12/31/2999 4/4/2006C9399 00641276543 12/31/2999 4/4/2006C9399 00641276641 12/31/2999 4/4/2006C9399 00641296541 12/31/2013 12/31/2999C9399 00641296545 12/31/2013 12/31/2999C9399 00641600710 12/31/2999 12/31/2999C9399 00641600810 12/31/2999 12/31/2999C9399 00641601310 12/31/2999 12/31/2999C9399 00641601410 12/31/2999 12/31/2999C9399 00641601510 12/31/2999 12/31/2999C9399 00641601806 12/31/2999 12/31/2999C9399 00641602110 12/31/2999 12/31/2999C9399 00641602225 12/31/2999 12/31/2999C9399 00641602325 12/31/2999 12/31/2999C9399 00641603110 12/31/2999 12/31/2999C9399 00641603210 12/31/2999 12/31/2999C9399 00641603325 12/31/2999 12/31/2999C9399 00641603425 12/31/2999 12/31/2999C9399 00641603525 12/31/2999 12/31/2999C9399 00641603610 12/31/2999 12/31/2999C9399 00641610425 12/31/2999 12/31/2999C9399 00641610525 12/31/2999 12/31/2999C9399 00641610625 12/31/2999 12/31/2999C9399 00641610710 12/31/2999 12/31/2999C9399 00703291403 12/31/2999 12/31/2999C9399 00703292503 12/31/2999 12/31/2999C9399 00703840104 12/31/2999 12/31/2999C9399 00703841104 12/31/2999 12/31/2999C9399 00703950303 12/31/2999 12/31/2999C9399 00703951403 12/31/2999 12/31/2999C9399 00703952601 12/31/2999 12/31/2999C9399 00781300370 12/31/2999 12/31/2999C9399 00781300375 12/31/2999 12/31/2999C9399 00781300392 12/31/2999 12/31/2999C9399 00781300395 12/31/2999 12/31/2999C9399 00781305271 12/31/2999 12/31/2999C9399 00781305295 12/31/2999 12/31/2999C9399 00781307195 12/31/2999 12/31/2999C9399 00781312485 12/31/2999 12/31/2999C9399 00781312495 12/31/2999 12/31/2999C9399 00781312585 12/31/2999 12/31/2999C9399 00781312592 12/31/2999 12/31/2999C9399 00781312595 12/31/2999 12/31/2999C9399 00781312646 12/31/2999 12/31/2999C9399 00781312695 12/31/2999 12/31/2999C9399 00781312892 12/31/2999 12/31/2999

Page 15: *This document is a compilation of NDC:HCPCS combinations

C9399 00781312992 12/31/2999 12/31/2999C9399 00781315972 12/31/2999 12/31/2999C9399 00781328809 12/31/2999 12/31/2999C9399 00781328909 12/31/2999 12/31/2999C9399 00781329009 12/31/2999 12/31/2999C9399 00781912495 12/31/2999 12/31/2999C9399 00781912595 12/31/2999 12/31/2999C9399 00781912695 12/31/2999 12/31/2999C9399 00781922492 12/31/2999 12/31/2999C9399 00781922592 12/31/2999 12/31/2999C9399 10019001571 12/31/2999 4/16/2002C9399 10019001602 4/30/2014 10/10/2012C9399 10019001617 3/31/2014 10/10/2012C9399 10019001629 4/30/2014 10/10/2012C9399 10019001636 1/31/2014 7/25/2012C9399 10019001637 3/31/2014 10/10/2012C9399 10019001639 3/31/2014 9/7/2012C9399 10019001654 1/31/2014 7/25/2012C9399 10019001681 3/31/2014 9/7/2012C9399 10019004502 3/31/2014 5/4/2012C9399 10019004517 3/31/2014 5/4/2012C9399 10019004603 2/28/2014 11/13/2012C9399 10019004604 1/31/2014 11/13/2012C9399 10019004614 1/31/2014 5/31/2005C9399 10019004663 2/28/2014 11/13/2012C9399 10019005561 12/31/2999 12/31/2999C9399 10019006001 12/31/2999 4/5/2006C9399 10019006002 12/31/2999 4/5/2006C9399 10019007587 12/31/2999 12/31/2999C9399 10019009503 12/31/2999 2/28/2006C9399 10019009504 12/31/2999 3/10/2005C9399 10019011501 12/31/2999 12/31/2999C9399 10019011539 12/31/2999 12/31/2999C9399 10019012001 12/31/2999 12/31/2999C9399 10019021004 12/31/2999 9/30/2008C9399 10019032102 1/31/2013 9/7/2012C9399 10019032162 1/31/2013 9/7/2012C9399 10019048202 12/31/2999 3/4/2003C9399 10019050602 12/31/2999 12/31/2999C9399 10019050610 5/31/2013 4/3/2012C9399 10019050636 5/31/2013 4/3/2012C9399 10019050637 2/28/2013 4/3/2012C9399 10019050639 12/31/2999 12/31/2999C9399 10019050645 2/28/2013 4/3/2012C9399 10019051001 9/30/2013 1/6/2012C9399 10019051002 8/31/2013 1/6/2012C9399 10019051004 9/30/2013 1/6/2012

Page 16: *This document is a compilation of NDC:HCPCS combinations

C9399 10019051078 8/31/2013 1/6/2012C9399 10019051079 9/30/2013 1/6/2012C9399 11098006020 12/31/2999 4/26/2005C9399 15054006001 12/31/2999 12/31/2999C9399 15054009001 12/31/2999 12/31/2999C9399 15054050001 12/31/2999 12/31/2999C9399 17478006702 12/31/2999 12/31/2999C9399 17478006705 12/31/2999 12/31/2999C9399 17478012050 12/31/2999 12/31/2999C9399 17478012150 12/31/2999 12/31/2999C9399 17478012250 12/31/2999 12/31/2999C9399 17478015142 12/31/2999 12/31/2999C9399 17478042020 12/31/2999 12/31/2999C9399 17478042040 12/31/2999 12/31/2999C9399 17478093705 12/31/2999 12/31/2999C9399 17478093710 12/31/2999 12/31/2999C9399 17478093725 12/31/2999 12/31/2999C9399 23360003105 12/31/2999 5/1/2011C9399 23360003110 12/31/2999 5/1/2011C9399 25021011502 12/31/2999 12/31/2999C9399 25021011504 12/31/2999 12/31/2999C9399 25021011506 12/31/2999 12/31/2999C9399 25021011551 12/31/2999 12/31/2999C9399 25021013182 12/31/2999 5/31/2010C9399 25021030020 12/31/2999 12/31/2999C9399 25021030040 12/31/2999 12/31/2999C9399 25021030305 12/31/2999 12/31/2999C9399 25021060005 12/31/2999 12/31/2999C9399 25021060010 12/31/2999 12/31/2999C9399 25021065710 12/31/2999 6/13/2013C9399 25021065820 12/31/2999 12/31/2999C9399 25021067410 12/31/2999 12/31/2999C9399 25021067420 12/31/2999 12/31/2999C9399 36000002612 12/31/2999 12/31/2999C9399 36000002712 12/31/2999 12/31/2999C9399 36000003310 12/31/2999 12/31/2999C9399 39822027702 12/31/2999 12/31/2999C9399 39822027705 12/31/2999 3/31/2012C9399 39822027707 12/31/2999 3/31/2012C9399 41616093140 12/31/2999 12/31/2999C9399 41616093144 12/31/2999 12/31/2999C9399 41616093244 12/31/2999 12/31/2999C9399 42023011310 12/31/2999 12/31/2999C9399 42023011410 12/31/2999 12/31/2999C9399 42023011510 12/31/2999 12/31/2999C9399 42023011725 12/31/2999 12/31/2999C9399 47783010101 12/31/2999 12/31/2999

Page 17: *This document is a compilation of NDC:HCPCS combinations

C9399 48818000101 12/31/2999 12/31/2999C9399 48818000102 12/31/2999 12/31/2999C9399 49502069303 12/31/2999 12/31/2999C9399 50242013501 12/31/2999 12/31/2999C9399 50242013601 12/31/2999 12/31/2999C9399 50242013701 12/31/2999 12/31/2999C9399 50242014501 12/31/2999 12/31/2999C9399 50458040101 12/31/2999 12/31/2999C9399 50458040102 12/31/2999 12/31/2999C9399 50458056001 12/31/2999 12/31/2999C9399 50458056101 12/31/2999 12/31/2999C9399 50458056201 12/31/2999 12/31/2999C9399 50458056301 12/31/2999 12/31/2999C9399 50458056401 12/31/2999 12/31/2999C9399 50474000263 12/31/2999 12/31/2999C9399 50474070062 12/31/2999 12/31/2999C9399 50633021011 12/31/2999 12/31/2999C9399 51144005001 12/31/2999 12/31/2999C9399 54569166000 12/31/2999 1/31/2003C9399 54569326000 12/31/2999 5/5/2011C9399 54569391600 12/31/2999 1/31/2003C9399 54569482100 12/31/2999 1/31/2003C9399 54569532200 12/31/2999 6/1/2003C9399 54868074100 12/31/2999 6/30/2011C9399 54868076500 12/31/2999 9/7/2012C9399 54868173800 12/31/2999 9/30/2011C9399 54868179500 12/31/2999 6/30/2012C9399 54868179801 12/31/2999 6/30/2012C9399 54868206400 12/31/2999 6/30/2012C9399 54868206401 12/31/2999 6/30/2012C9399 54868313400 12/31/2999 7/31/2011C9399 54868313401 12/31/2999 12/31/2999C9399 54868323101 12/31/2999 6/30/2001C9399 54868339200 12/31/2999 6/30/2011C9399 54868343700 12/31/2999 6/30/2012C9399 54868369500 12/31/2999 6/30/2011C9399 54868380900 12/31/2999 6/30/2011C9399 54868380901 12/31/2999 6/30/2011C9399 54868392000 12/31/2999 2/10/2009C9399 54868415400 12/31/2999 6/30/2011C9399 54868416900 12/31/2999 6/30/2010C9399 54868439900 12/31/2999 6/30/2012C9399 54868448600 12/31/2999 6/30/2011C9399 54868459600 12/31/2999 6/30/2011C9399 54868462900 12/31/2999 6/30/2011C9399 54868488700 12/31/2999 6/30/2011C9399 54868509300 12/31/2999 6/30/2011

Page 18: *This document is a compilation of NDC:HCPCS combinations

C9399 54868570900 12/31/2999 12/31/2999C9399 54868571500 12/31/2999 12/31/2999C9399 54868571800 12/31/2999 6/30/2011C9399 54868572300 12/31/2999 6/30/2012C9399 54868572600 12/31/2999 6/30/2012C9399 54868574000 12/31/2999 12/31/2999C9399 54868574001 12/31/2999 12/31/2999C9399 54868626700 12/31/2999 12/31/2999C9399 55150016710 12/31/2999 12/31/2999C9399 55150016830 12/31/2999 12/31/2999C9399 55150016910 12/31/2999 12/31/2999C9399 55150017030 12/31/2999 12/31/2999C9399 55150017110 12/31/2999 12/31/2999C9399 55150017230 12/31/2999 12/31/2999C9399 55390001010 12/31/2999 12/31/2999C9399 55390001110 12/31/2999 12/31/2999C9399 55390002601 12/31/2999 12/31/2999C9399 55390002701 12/31/2999 12/31/2999C9399 55390002810 12/31/2999 12/31/2999C9399 55390002910 12/31/2999 12/31/2999C9399 55390003501 12/31/2999 12/31/2999C9399 55390003710 12/31/2999 12/31/2999C9399 55390003910 12/31/2999 12/31/2999C9399 55390006210 12/31/2999 12/31/2999C9399 55390007310 12/31/2999 12/31/2999C9399 55390009210 12/31/2999 12/31/2999C9399 55390009310 12/31/2999 12/31/2999C9399 55390010601 12/31/2999 12/31/2999C9399 55390012301 12/31/2999 12/31/2999C9399 55390013020 12/31/2999 12/31/2999C9399 55390013040 12/31/2999 12/31/2999C9399 55390034010 12/31/2999 4/18/2013C9399 55390034810 12/31/2999 4/18/2013C9399 55390047510 12/31/2999 12/31/2999C9399 55390050002 12/31/2999 12/31/2999C9399 55390050005 12/31/2999 12/31/2999C9399 55390050010 12/31/2999 12/31/2999C9399 55390056505 12/31/2999 12/31/2999C9399 55390056510 12/31/2999 12/31/2999C9399 55390056530 12/31/2999 12/31/2999C9399 55390056605 12/31/2999 4/18/2013C9399 55390056610 12/31/2999 4/18/2013C9399 55390056630 12/31/2999 4/18/2013C9399 55390076210 12/31/2999 12/31/2999C9399 55390076320 12/31/2999 12/31/2999C9399 55513071001 12/31/2999 12/31/2999C9399 55513073001 12/31/2999 12/31/2999

Page 19: *This document is a compilation of NDC:HCPCS combinations

C9399 55566830101 12/31/2999 12/31/2999C9399 55566840101 12/31/2999 12/31/2999C9399 57894006003 12/31/2999 12/31/2999C9399 58016499601 12/31/2999 11/29/2012C9399 58016933101 12/31/2999 11/29/2012C9399 58016934301 12/31/2999 10/17/2012C9399 58394001201 12/31/2999 12/31/2999C9399 58394001301 12/31/2999 12/31/2999C9399 58394001401 12/31/2999 12/31/2999C9399 58394001501 12/31/2999 12/31/2999C9399 58468014001 12/31/2999 12/31/2999C9399 58468015001 12/31/2999 12/31/2999C9399 58468016001 12/31/2999 12/31/2999C9399 59338077501 12/31/2999 12/31/2999C9399 59338077510 12/31/2999 12/31/2999C9399 59730560101 12/31/2999 1/9/2009C9399 60505070401 12/31/2999 2/3/2006C9399 60505070402 12/31/2999 2/3/2006C9399 60505071700 12/31/2999 10/1/2011C9399 60505071701 12/31/2999 7/3/2006C9399 60505071702 12/31/2999 8/1/2008C9399 60505071703 12/31/2999 8/1/2008C9399 60977014402 6/30/2013 5/4/2012C9399 60977014463 6/30/2013 5/4/2012C9399 60977015501 3/31/2014 10/19/2012C9399 60977015502 3/31/2014 10/19/2012C9399 60977015503 1/31/2014 7/25/2012C9399 60977015504 12/31/2999 2/22/2006C9399 60977015506 10/31/2013 7/25/2012C9399 60977015554 1/31/2014 7/25/2012C9399 61553019341 12/31/2999 12/31/2999C9399 61553024337 12/31/2999 12/31/2999C9399 61553024802 12/31/2999 12/31/2999C9399 61703021309 12/31/2999 5/24/2002C9399 61703021311 12/31/2999 5/24/2002C9399 61703021321 12/31/2999 5/24/2002C9399 61703023322 12/31/2999 8/1/2006C9399 61703023341 12/31/2999 8/1/2006C9399 61958090101 12/31/2999 12/31/2999C9399 62856038901 12/31/2999 12/31/2999C9399 63323002605 12/31/2999 12/31/2999C9399 63323003250 12/31/2999 12/31/2007C9399 63323003261 12/31/2999 12/31/2999C9399 63323006620 12/31/2999 12/31/2007C9399 63323006650 12/31/2999 12/31/2007C9399 63323006661 12/31/2999 12/31/2007C9399 63323011410 12/31/2999 12/31/2007

Page 20: *This document is a compilation of NDC:HCPCS combinations

C9399 63323013011 12/31/2999 12/31/2999C9399 63323013013 12/31/2999 12/31/2999C9399 63323018410 12/31/2999 12/31/2999C9399 63323018411 12/31/2999 12/31/2999C9399 63323020102 12/31/2999 12/31/2999C9399 63323020110 12/31/2999 12/31/2999C9399 63323020202 12/31/2999 12/31/2999C9399 63323020805 12/31/2999 12/31/2999C9399 63323026920 12/31/2999 3/7/2013C9399 63323026927 12/31/2999 12/31/2999C9399 63323026929 12/31/2999 12/31/2999C9399 63323026937 12/31/2999 12/31/2999C9399 63323026950 12/31/2999 12/31/2999C9399 63323026957 12/31/2999 12/31/2999C9399 63323026959 12/31/2999 12/31/2999C9399 63323026965 12/31/2999 12/31/2999C9399 63323026967 12/31/2999 12/31/2999C9399 63323026969 12/31/2999 12/31/2999C9399 63323026994 12/31/2999 12/31/2999C9399 63323027025 12/31/2999 12/31/2999C9399 63323027026 12/31/2999 12/31/2999C9399 63323027027 1/30/2013 6/8/2011C9399 63323027050 12/31/2999 12/31/2999C9399 63323027057 12/31/2999 12/31/2999C9399 63323027065 12/31/2999 12/31/2999C9399 63323027067 12/31/2999 12/31/2999C9399 63323028202 12/31/2999 12/31/2999C9399 63323028204 12/31/2999 12/31/2999C9399 63323028206 12/31/2999 12/31/2999C9399 63323028260 12/31/2999 12/31/2999C9399 63323029730 12/31/2999 12/31/2999C9399 63323029731 12/31/2999 2/1/2013C9399 63323029750 12/31/2999 12/31/2999C9399 63323029751 12/31/2999 2/1/2013C9399 63323029753 12/31/2999 2/1/2013C9399 63323029766 12/31/2999 12/31/2999C9399 63323030201 12/31/2999 12/31/2999C9399 63323032930 12/31/2999 12/31/2999C9399 63323040120 12/31/2999 12/31/2999C9399 63323040220 12/31/2999 12/31/2999C9399 63323042405 12/31/2999 12/31/2999C9399 63323042410 12/31/2999 12/31/2999C9399 63323046410 4/30/2015 11/8/2011C9399 63323046417 12/31/2999 12/31/2999C9399 63323046430 9/30/2014 1/21/2011C9399 63323046431 12/31/2999 12/31/2999C9399 63323046433 12/31/2999 12/31/2999

Page 21: *This document is a compilation of NDC:HCPCS combinations

C9399 63323046437 12/31/2999 12/31/2999C9399 63323046550 3/30/2015 9/8/2011C9399 63323046557 12/31/2999 12/31/2999C9399 63323046610 5/30/2014 5/18/2011C9399 63323046617 12/31/2999 12/31/2999C9399 63323046630 12/30/2013 2/4/2011C9399 63323046631 12/31/2999 12/31/2999C9399 63323046633 12/31/2999 12/31/2999C9399 63323046637 12/31/2999 12/31/2999C9399 63323046750 3/30/2015 6/24/2011C9399 63323046757 12/31/2999 12/31/2999C9399 63323047210 12/31/2999 2/13/2012C9399 63323047217 12/31/2999 12/31/2999C9399 63323047230 6/30/2013 3/2/2011C9399 63323047233 12/31/2999 12/31/2999C9399 63323047237 12/31/2999 12/31/2999C9399 63323048520 10/30/2014 4/26/2011C9399 63323048550 3/30/2015 9/27/2011C9399 63323048610 5/30/2014 9/21/2011C9399 63323048620 12/30/2014 9/8/2011C9399 63323049089 12/31/2999 12/31/2999C9399 63323049150 11/30/2013 1/6/2011C9399 63323049202 4/30/2015 8/2/2011C9399 63323049205 3/30/2014 1/20/2011C9399 63323049230 6/30/2014 1/21/2011C9399 63323049231 12/31/2999 12/31/2999C9399 63323049280 12/31/2999 12/31/2999C9399 63323049289 12/31/2999 12/31/2999C9399 63323049297 12/31/2999 12/31/2999C9399 63323049391 12/31/2999 12/31/2999C9399 63323049397 12/31/2999 12/31/2999C9399 63323049405 12/31/2999 12/31/2999C9399 63323049502 12/30/2014 11/30/2010C9399 63323049505 1/30/2015 4/1/2011C9399 63323049680 12/31/2999 12/31/2999C9399 63323049697 12/31/2999 12/31/2999C9399 63323049889 12/31/2999 12/31/2999C9399 63323065210 12/31/2999 12/31/2999C9399 63323066005 12/31/2999 12/31/2999C9399 63323073804 12/31/2999 11/13/2012C9399 63323073809 12/31/2999 12/31/2999C9399 63323073820 12/31/2999 12/31/2999C9399 63323073912 12/31/2999 12/31/2999C9399 63459039120 12/31/2999 12/31/2999C9399 63833082502 12/31/2999 12/31/2999C9399 64208823401 12/31/2999 12/31/2999C9399 64208823402 12/31/2999 12/31/2999

Page 22: *This document is a compilation of NDC:HCPCS combinations

C9399 64208823403 12/31/2999 12/31/2999C9399 65293000200 12/31/2999 10/3/2011C9399 65293000211 5/31/2012 10/3/2011C9399 65293000250 12/31/2999 10/3/2011C9399 65293000255 5/31/2012 10/3/2011C9399 65293000500 12/31/2999 12/31/2999C9399 65293000511 12/31/2999 12/31/2999C9399 65293000550 12/31/2999 12/31/2999C9399 65293000555 12/31/2999 12/31/2999C9399 65483035502 12/31/2999 2/10/2009C9399 65483035504 12/31/2999 2/10/2009C9399 66302020601 12/31/2999 12/31/2999C9399 66302020602 12/31/2999 12/31/2999C9399 66302020603 12/31/2999 12/31/2999C9399 66479002539 12/31/2999 5/13/2005C9399 66658023407 12/31/2999 12/31/2999C9399 66658023428 12/31/2999 12/31/2999C9399 66860012002 12/31/2999 12/31/2999C9399 66887000301 12/31/2999 12/31/2999C9399 67457000110 12/31/2999 12/31/2999C9399 67457010810 12/31/2999 12/31/2999C9399 67457011850 12/31/2999 12/31/2999C9399 67457018120 12/31/2999 12/31/2999C9399 67457018210 12/31/2999 12/31/2999C9399 67457018320 12/31/2999 12/31/2999C9399 67457018750 12/31/2999 12/31/2999C9399 67457019015 12/31/2999 12/31/2999C9399 67457019115 12/31/2999 9/1/2011C9399 67457019205 12/31/2999 12/31/2999C9399 67467018101 2/12/2013 12/31/2999C9399 67467018102 9/15/2013 12/31/2999C9399 76075010101 12/31/2999 12/31/2999C9399 76125090001 12/31/2999 12/31/2999C9399 76125090010 12/31/2999 12/31/2999C9399 76125090020 12/31/2999 12/31/2999C9399 76125090025 12/31/2999 12/31/2999C9399 76125090050 12/31/2999 12/31/2999C9406 17156021001 12/31/2999 12/31/2999C9441 00517065001 12/31/2999 12/31/2999C9497 57844051055 12/31/2999 12/31/2999G9017 00121064610 12/31/2999 12/31/2999G9017 00121064616 12/31/2999 12/31/2999G9017 00527170401 12/31/2999 12/31/2999G9017 00527170405 12/31/2999 12/31/2999G9017 00781204801 12/31/2999 12/31/2999G9017 00781204805 12/31/2999 12/31/2999G9017 00832011100 12/31/2999 12/31/2999

Page 23: *This document is a compilation of NDC:HCPCS combinations

G9017 00832011150 12/31/2999 12/31/2999G9017 00832101500 12/31/2999 12/31/2999G9017 00832101550 12/31/2999 12/31/2999G9017 16590000810 12/31/2999 12/31/2999G9017 16590000814 12/31/2999 12/31/2999G9017 16590000820 12/31/2999 12/31/2999G9017 16590000830 12/31/2999 12/31/2999G9017 21695056410 12/31/2999 12/31/2999G9017 23490503701 12/31/2999 12/31/2999G9017 23490503702 12/31/2999 12/31/2999G9017 49999032415 12/31/2999 12/31/2999G9017 49999032420 12/31/2999 12/31/2999G9017 50383080716 12/31/2999 12/31/2999G9017 51079048101 11/30/2013 12/31/2999G9017 51079048120 11/30/2013 12/31/2999G9017 52959000710 12/31/2999 12/31/2999G9017 52959000714 12/31/2999 12/31/2999G9017 52959000715 12/31/2999 12/31/2999G9017 52959000720 12/31/2999 12/31/2999G9017 52959000730 12/31/2999 12/31/2999G9017 52959000760 12/31/2999 12/31/2999G9017 54569008402 12/31/2999 12/31/2999G9017 54569008403 12/31/2999 12/31/2999G9017 54569563500 12/31/2999 9/1/2012G9017 54868080000 12/31/2999 12/31/2999G9017 54868080001 12/31/2999 12/31/2999G9017 54868080002 12/31/2999 12/31/2999G9017 54868080003 12/31/2999 12/31/2999G9017 54868080004 12/31/2999 6/30/2011G9017 54868080007 12/31/2999 6/30/2012G9017 55289001210 12/31/2999 12/31/2999G9017 55289001214 12/31/2999 12/31/2999G9017 55289001220 12/31/2999 12/31/2999G9017 58016015300 12/31/2999 11/29/2012G9017 58016015302 12/31/2999 11/29/2012G9017 58016015310 12/31/2999 11/29/2012G9017 58016015314 12/31/2999 11/29/2012G9017 58016015315 12/31/2999 11/29/2012G9017 58016015320 12/31/2999 11/29/2012G9017 58016015330 12/31/2999 11/29/2012G9017 58864079510 12/31/2999 12/31/2999G9017 60432009316 12/31/2999 12/31/2999G9017 62584061201 12/31/2999 5/31/2012G9017 62584061211 12/31/2999 5/31/2012G9017 63629268101 12/31/2999 12/31/2999G9017 66267001514 12/31/2999 12/31/2999G9017 66267001520 12/31/2999 12/31/2999

Page 24: *This document is a compilation of NDC:HCPCS combinations

G9019 00004080085 12/31/2999 12/31/2999G9020 00115191101 12/31/2999 12/31/2999G9020 49999092030 12/31/2999 12/31/2999G9020 55289083214 12/31/2999 12/31/2999G9020 63629355201 12/31/2999 12/31/2999G9034 00173068101 12/31/2999 12/31/2999G9034 54868437700 12/31/2999 12/31/2999G9035 00004080085 12/31/2999 12/31/2999G9035 35356047825 12/31/2999 11/28/2011G9035 49999029810 12/31/2999 12/31/2999G9035 52959080110 12/31/2999 12/31/2999G9035 52959083200 12/31/2999 2/9/2012G9035 54569488800 12/31/2999 12/31/2999G9035 54569561500 12/31/2999 7/11/2011G9035 54868447600 12/31/2999 12/31/2999G9035 58016478901 12/31/2999 11/29/2012G9036 23490650001 12/31/2999 12/31/2999G9036 49999092030 12/31/2999 12/31/2999G9036 52959049010 12/31/2999 12/31/2999G9036 52959049014 12/31/2999 12/31/2999G9036 52959049020 12/31/2999 12/31/2999G9036 54868344100 12/31/2999 6/30/2010G9036 63629355201 12/31/2999 12/31/2999J0129 00003218710 12/31/2999 12/31/2999J0130 00002714001 12/31/2999 12/31/2999J0131 43825010201 12/31/2999 12/31/2999J0132 00574080530 12/31/2999 12/31/2999J0132 00574081530 12/31/2999 12/31/2999J0132 63323096330 12/31/2999 12/31/2999J0132 66220010730 12/31/2999 2/9/2011J0132 66220010734 12/31/2999 2/9/2011J0132 66220020730 12/31/2999 12/31/2999J0133 55390061210 12/31/2999 12/31/2999J0133 55390061320 12/31/2999 12/31/2999J0133 63323010510 12/31/2999 12/31/2999J0133 63323032510 12/31/2999 12/31/2999J0133 63323032520 12/31/2999 12/31/2999J0135 00074379902 12/31/2999 12/31/2999J0135 00074433902 12/31/2999 12/31/2999J0135 00074433906 12/31/2999 12/31/2999J0135 00074433907 12/31/2999 12/31/2999J0135 00074937402 12/31/2999 12/31/2999J0135 54868482200 12/31/2999 6/30/2011J0150 00469823412 12/31/2999 12/31/2999J0150 00469823414 12/31/2999 12/31/2999J0150 00641611310 12/31/2999 12/31/2999J0150 10019006302 3/31/2013 5/4/2012

Page 25: *This document is a compilation of NDC:HCPCS combinations

J0150 10019006303 3/31/2013 5/4/2012J0150 10019006307 12/31/2999 5/1/2009J0150 17478054202 12/31/2999 12/31/2999J0150 17478054225 12/31/2999 12/31/2999J0150 25021030102 12/31/2999 12/31/2999J0150 25021030104 12/31/2999 12/31/2999J0150 25021030172 12/31/2999 12/31/2999J0150 25021030176 12/31/2999 12/31/2999J0150 55390006710 12/31/2999 12/31/2999J0150 55390006801 12/31/2999 12/31/2999J0150 63323065102 12/31/2999 12/31/2999J0150 63323065104 12/31/2999 12/31/2999J0150 64679063001 12/31/2999 12/31/2999J0150 64679063002 4/6/2013 4/6/2013J0150 64679063007 12/31/2999 12/31/2999J0150 64679063008 4/6/2013 4/6/2013J0151 00703877601 12/31/2999 12/31/2999J0151 00703877701 12/31/2999 12/31/2999J0152 00469087120 12/31/2999 12/31/2999J0152 00469087130 12/31/2999 12/31/2999J0152 54868582500 12/31/2999 6/30/2012J0152 54868582501 12/31/2999 6/30/2012J0171 00143998490 12/31/2999 5/13/2011J0171 00409490118 12/31/2999 12/31/2999J0171 00409492134 12/31/2999 12/31/2999J0171 00409724101 12/31/2999 12/31/2999J0171 00409724161 12/31/2999 12/31/2999J0171 00517107125 12/31/2999 12/31/2999J0171 00517113005 12/31/2999 12/31/2999J0171 00548331600 1/31/2014 10/5/2012J0171 00548906100 7/31/2014 9/13/2012J0171 42023010101 12/31/2999 12/31/2999J0171 42023010110 12/31/2999 12/31/2999J0171 42023012225 12/31/2999 12/31/2999J0171 42023015925 12/31/2999 12/31/2999J0171 54569167300 12/31/2999 1/31/2003J0171 54569307500 12/31/2999 1/31/2003J0171 54569307501 12/31/2999 1/31/2003J0171 54868136300 12/31/2999 6/30/2008J0171 54868206500 12/31/2999 6/30/2011J0171 54868206501 12/31/2999 6/30/2011J0171 54868364100 12/31/2999 6/30/2011J0171 55045990303 12/31/2999 10/7/2009J0171 66860002001 12/31/2999 8/11/2009J0171 66860002102 12/31/2999 12/31/2999J0178 61755000502 12/31/2999 12/31/2999J0180 58468004001 12/31/2999 12/31/2999

Page 26: *This document is a compilation of NDC:HCPCS combinations

J0180 58468004101 12/31/2999 12/31/2999J0205 58468106001 12/31/2999 3/30/2012J0207 47335058140 12/31/2999 12/31/2999J0207 47335058142 12/31/2999 12/31/2999J0207 55390030803 12/31/2999 12/31/2999J0207 58178001701 12/31/2999 3/31/2012J0207 58178001703 12/31/2999 3/31/2012J0207 62756058140 12/31/2999 12/31/2999J0207 62756058142 12/31/2999 12/31/2999J0210 00074303001 12/31/2999 5/2/2011J0210 00074303002 12/31/2999 5/2/2011J0210 00517890510 12/31/2999 12/31/2999J0215 00469002103 12/31/2999 11/16/2011J0215 00469002104 12/31/2999 11/16/2011J0220 58468015001 12/31/2999 12/31/2999J0221 58468016001 12/31/2999 12/31/2999J0256 00053720102 12/31/2999 12/31/2999J0256 00944280101 12/31/2999 12/30/2008J0256 00944280201 12/31/2999 12/31/2999J0256 00944280202 12/31/2999 12/31/2999J0256 00944282202 2/28/2013 12/31/2999J0256 13533060130 12/31/2999 12/17/2012J0256 13533070001 12/31/2999 12/31/2999J0256 13533070002 12/31/2999 12/31/2999J0257 00944288401 12/31/2999 12/31/2999J0270 00009316906 12/31/2999 12/31/2999J0270 00009370105 12/31/2999 12/31/2999J0270 00009370108 12/31/2999 12/31/2999J0270 00009518101 12/31/2999 12/31/2999J0270 00009518201 12/31/2999 12/31/2999J0270 00009765002 12/31/2999 12/31/2999J0270 00009768601 12/31/2999 12/31/2999J0270 00009768604 12/31/2999 12/31/2999J0270 00091111016 12/31/2999 3/26/2012J0270 00091111020 12/31/2999 5/23/2012J0270 00091112016 12/31/2999 1/23/2012J0270 00091112020 12/31/2999 3/12/2012J0270 00091114016 12/31/2999 5/31/2012J0270 00703150101 12/31/2999 4/8/2009J0270 00703150102 12/31/2999 12/31/2999J0270 54868489000 12/31/2999 5/10/2012J0270 55390050610 12/31/2999 5/2/2011J0275 62541013001 7/31/2013 12/13/2011J0275 62541013006 7/31/2013 12/13/2011J0275 62541014001 7/31/2013 12/14/2011J0275 62541014006 7/31/2013 12/14/2011J0278 00409195501 12/31/2999 12/31/2999

Page 27: *This document is a compilation of NDC:HCPCS combinations

J0278 00409195701 12/31/2999 12/31/2999J0278 00703903201 12/31/2999 12/31/2999J0278 00703903203 12/31/2999 12/31/2999J0278 00703904001 12/31/2999 12/31/2999J0278 00703904003 12/31/2999 12/31/2999J0278 54868571800 12/31/2999 6/30/2011J0278 55390022502 12/31/2999 5/2/2011J0278 55390022602 12/31/2999 12/31/2999J0278 55390022604 12/31/2999 12/31/2999J0280 00409592101 12/31/2999 12/31/2999J0280 00409592201 12/31/2999 12/31/2999J0280 00409738501 12/31/2999 12/31/2999J0280 00517381025 12/31/2999 12/1/2011J0280 00517382025 12/31/2999 12/1/2011J0282 00143987510 12/31/2999 12/31/2999J0282 00409434835 12/31/2999 12/31/2999J0282 00409434849 12/31/2999 12/31/2999J0282 00703133201 12/31/2999 1/15/2011J0282 54868572200 12/31/2999 12/31/2999J0282 55390005701 12/31/2999 5/2/2011J0282 55390005710 12/31/2999 5/2/2011J0282 55390010501 12/31/2999 5/2/2011J0282 63323061603 12/31/2999 12/31/2999J0282 63323061609 12/31/2999 12/31/2999J0282 67457015303 12/31/2999 12/31/2999J0282 67457015309 12/31/2999 12/31/2999J0282 67457015318 12/31/2999 12/31/2999J0285 39822105505 12/31/2999 12/31/2999J0285 39822105507 12/31/2999 11/19/2011J0285 54868575200 12/31/2999 6/30/2011J0287 57665010141 12/31/2999 12/31/2999J0288 66435030151 12/31/2999 9/12/2011J0288 66435030201 12/31/2999 9/12/2011J0289 00469305130 12/31/2999 12/31/2999J0290 00069002601 10/31/2013 6/27/2012J0290 00069002710 10/31/2013 7/5/2012J0290 00069002918 10/31/2013 6/19/2012J0290 00069004631 10/31/2013 7/3/2012J0290 00069006525 10/31/2013 6/28/2012J0290 00069007128 10/31/2013 7/5/2012J0290 00781340078 12/31/2999 12/31/2999J0290 00781340095 12/31/2999 12/31/2999J0290 00781340278 12/31/2999 12/31/2999J0290 00781340295 12/31/2999 12/31/2999J0290 00781340485 12/31/2999 12/31/2999J0290 00781340495 12/31/2999 12/31/2999J0290 00781340795 12/31/2999 12/31/2999

Page 28: *This document is a compilation of NDC:HCPCS combinations

J0290 00781340895 12/31/2999 12/31/2999J0290 00781340995 12/31/2999 12/31/2999J0290 00781341292 12/31/2999 12/31/2999J0290 00781341392 12/31/2999 12/31/2999J0290 00781940195 12/31/2999 12/31/2999J0290 00781940278 12/31/2999 12/31/2999J0290 00781940295 12/31/2999 12/31/2999J0290 00781940495 12/31/2999 12/31/2999J0290 00781940778 12/31/2999 12/31/2999J0290 00781940795 12/31/2999 12/31/2999J0290 00781940880 12/31/2999 12/31/2999J0290 00781940895 12/31/2999 12/31/2999J0290 00781940995 12/31/2999 12/31/2999J0290 00781941292 12/31/2999 12/31/2999J0290 00781941392 12/31/2999 12/31/2999J0290 25021013410 12/31/2999 12/31/2999J0290 25021013510 12/31/2999 12/31/2999J0290 25021013610 12/31/2999 12/31/2999J0290 25021013720 12/31/2999 12/31/2999J0290 25021013899 12/31/2999 12/31/2999J0290 36000007210 12/31/2999 12/31/2999J0290 44567010010 12/31/2999 12/31/2999J0290 44567010110 12/31/2999 12/31/2999J0290 44567010210 12/31/2999 12/31/2999J0290 44567010310 12/31/2999 12/31/2999J0290 44567010410 12/31/2999 12/31/2999J0290 54569153000 12/31/2999 1/31/2003J0290 54868348100 12/31/2999 6/30/2011J0290 54868404700 12/31/2999 6/30/2011J0290 63323038710 12/31/2999 12/31/2999J0290 63323038810 12/31/2999 12/31/2999J0290 63323038910 12/31/2999 12/31/2999J0290 63323039923 12/31/2999 12/31/2999J0290 66860001102 12/31/2999 12/31/2999J0290 66860001202 12/31/2999 12/31/2999J0290 66860001302 12/31/2999 12/31/2999J0290 66860001502 12/31/2999 12/31/2999J0295 00049001383 12/31/2999 12/31/2999J0295 00049001483 12/31/2999 12/31/2999J0295 00049002283 12/31/2999 5/17/2013J0295 00049002383 12/31/2013 8/17/2011J0295 00049002428 12/31/2999 12/31/2999J0295 00049003183 6/30/2013 3/2/2012J0295 00049003283 12/31/2999 10/27/2011J0295 00409268715 12/31/2999 12/31/2999J0295 00409268901 12/31/2999 12/31/2999J0295 00409268911 12/31/2999 12/31/2999

Page 29: *This document is a compilation of NDC:HCPCS combinations

J0295 00409298703 12/31/2999 12/31/2999J0295 00409298713 12/31/2999 12/31/2999J0295 00409298801 12/31/2999 12/31/2999J0295 00409299803 12/31/2999 12/31/2999J0295 00641611610 12/31/2999 12/31/2999J0295 00641611710 12/31/2999 12/31/2999J0295 00641611801 12/31/2999 12/31/2999J0295 00641611910 12/31/2999 12/31/2999J0295 00641612010 12/31/2999 12/31/2999J0295 00641612101 12/31/2999 12/31/2999J0295 00641612310 12/31/2999 12/31/2999J0295 00781303295 12/31/2999 12/31/2999J0295 00781303395 12/31/2999 12/31/2999J0295 00781303446 12/31/2999 12/31/2999J0295 10019063002 10/31/2013 3/23/2012J0295 10019063033 10/31/2013 3/23/2012J0295 10019063101 10/31/2013 3/23/2012J0295 10019063131 10/31/2013 3/23/2012J0295 10019063203 10/31/2013 3/23/2012J0295 10019063215 10/31/2013 3/23/2012J0295 10019063302 7/31/2013 12/31/2999J0295 10019063333 7/31/2013 12/31/2999J0295 10019063401 7/31/2013 2/1/2013J0295 10019063431 7/31/2013 2/1/2013J0295 10019063503 2/28/2013 2/1/2013J0295 10019063515 2/28/2013 2/1/2013J0295 10019063601 10/31/2013 3/27/2012J0295 10019063631 10/31/2013 3/27/2012J0295 10019063702 10/31/2013 3/27/2012J0295 10019063733 10/31/2013 3/27/2012J0295 10019063803 10/31/2013 5/16/2012J0295 10019063815 10/31/2013 5/16/2012J0295 10139007011 12/31/2999 4/30/2013J0295 10139007012 12/31/2999 4/30/2013J0295 10139007110 2/28/2014 11/13/2012J0295 10139007118 2/28/2014 11/13/2012J0295 25021014220 12/31/2999 12/31/2999J0295 25021014330 12/31/2999 12/31/2999J0295 25021014499 12/31/2999 12/31/2999J0295 44567021110 12/31/2999 12/31/2999J0295 44567021201 12/31/2999 12/31/2999J0295 63323031461 12/31/2999 12/31/2999J0295 63323036820 12/31/2999 12/31/2999J0295 63323036920 12/31/2999 12/31/2999J0295 63323037062 12/31/2999 12/31/2999J0295 67457022615 12/31/2999 12/31/2999J0295 67457023010 12/31/2999 12/31/2999

Page 30: *This document is a compilation of NDC:HCPCS combinations

J0300 42998030301 12/31/2999 12/31/2999J0330 00409662902 12/31/2999 12/31/2999J0330 00409662961 12/31/2999 12/31/2999J0330 00409697010 12/31/2999 12/31/2999J0330 00781300970 12/31/2999 12/31/2999J0330 00781300995 12/31/2999 12/31/2999J0330 61553031370 12/31/2999 12/31/2999J0348 00049011428 12/31/2999 12/31/2999J0348 00049011628 12/31/2999 12/31/2999J0360 00517090125 12/31/2999 12/31/2999J0360 17478083401 12/31/2999 12/31/2999J0360 17478083415 12/31/2999 12/31/2999J0360 17478093401 12/31/2999 12/31/2999J0360 17478093415 12/31/2999 12/31/2999J0360 63323061401 12/31/2999 12/31/2999J0360 63323061455 12/31/2999 12/31/2999J0364 15054021101 12/31/2999 12/31/2999J0364 15054021105 12/31/2999 12/31/2999J0364 27505000405 12/31/2999 12/31/2999J0365 00026819636 12/31/2999 5/14/2008J0365 00026819763 12/31/2999 5/14/2008J0400 59148001665 12/31/2999 12/31/2999J0401 59148001871 12/31/2999 12/31/2999J0401 59148001971 12/31/2999 12/31/2999J0456 00069315014 5/31/2014 1/10/2013J0456 00069315083 12/31/2999 12/31/2999J0456 00409014411 12/31/2999 12/31/2999J0456 25021011210 12/31/2999 12/31/2999J0456 50111079478 12/31/2999 12/31/2999J0456 54868452700 12/31/2999 6/30/2011J0456 60505607604 12/31/2999 12/31/2999J0456 62756051244 12/31/2999 12/31/2999J0456 63323039810 12/31/2999 12/31/2999J0456 63323039812 12/31/2999 12/31/2999J0461 00409163010 12/31/2999 12/31/2999J0461 00409491034 12/31/2999 12/31/2999J0461 00409491134 12/31/2999 12/31/2999J0461 00409962905 12/31/2999 3/1/2008J0461 00409963005 12/31/2999 12/31/2999J0461 00517040125 12/31/2999 12/31/2999J0461 00517101025 12/31/2999 12/31/2999J0461 00548333900 12/31/2013 9/24/2012J0461 00641600610 12/31/2999 12/31/2999J0461 10019025012 12/31/2013 12/31/2999J0461 10019025020 12/31/2013 4/3/2012J0461 10019025112 12/31/2999 12/31/2999J0461 54569223600 12/31/2999 1/31/2003

Page 31: *This document is a compilation of NDC:HCPCS combinations

J0461 54569358900 12/31/2999 1/31/2003J0461 54868000600 12/31/2999 12/31/2999J0461 54868074000 12/31/2999 7/19/2000J0461 54868074001 12/31/2999 4/30/2011J0461 54868389300 12/31/2999 6/30/2011J0461 63323024601 12/31/2999 12/31/2007J0470 11098052603 2/28/2014 6/14/2012J0470 17478052603 12/31/2999 12/31/2999J0475 45945015501 12/31/2999 12/31/2999J0475 45945015502 12/31/2999 12/31/2999J0475 45945015601 12/31/2999 12/31/2999J0475 45945015602 12/31/2999 12/31/2999J0475 45945015701 12/31/2999 12/31/2999J0475 45945015702 12/31/2999 12/31/2999J0475 58281056001 12/31/2999 12/31/2999J0475 58281056002 12/31/2999 12/31/2999J0475 58281056102 12/31/2999 12/31/2999J0475 58281056301 12/31/2999 12/31/2999J0475 58281056302 12/31/2999 12/31/2999J0476 45945015101 12/31/2999 12/31/2999J0476 58281056201 12/31/2999 12/31/2999J0480 00078033184 12/31/2999 12/31/2999J0480 00078039361 12/31/2999 12/31/2999J0485 00003037113 12/31/2999 12/31/2999J0490 49401010101 12/31/2999 12/31/2999J0490 49401010201 12/31/2999 12/31/2999J0500 55390006610 12/31/2999 5/2/2011J0500 58914008052 12/31/2999 12/31/2999J0515 00143972905 12/31/2999 12/31/2999J0515 17478001202 12/31/2999 12/31/2999J0515 63323097002 12/31/2999 12/31/2999J0515 67386061152 11/30/2013 7/26/2012J0515 76478061102 12/31/2999 12/31/2999J0558 54569595700 12/31/2999 12/31/2999J0558 54569595800 12/31/2999 12/31/2999J0558 60793060010 12/31/2999 12/31/2999J0558 60793060110 12/31/2999 12/31/2999J0558 60793060210 12/31/2999 12/31/2999J0558 61570014010 12/31/2999 8/15/2007J0561 60793070010 12/31/2999 12/31/2999J0561 60793070110 12/31/2999 12/31/2999J0561 60793070210 12/31/2999 12/31/2999J0583 65293000101 12/31/2999 12/31/2999J0583 65293000422 12/31/2999 2/12/2013J0585 00023114501 12/31/2999 12/31/2999J0585 00023391950 12/31/2999 12/31/2999J0585 00023392102 12/31/2999 12/31/2999

Page 32: *This document is a compilation of NDC:HCPCS combinations

J0585 00023923201 12/31/2999 12/31/2999J0585 54868412300 12/31/2999 6/30/2011J0586 15054050001 12/31/2999 12/31/2999J0586 15054053006 12/31/2999 12/31/2999J0586 99207050030 12/31/2999 12/31/2999J0587 10454071010 12/31/2999 12/31/2999J0587 10454071110 12/31/2999 12/31/2999J0587 10454071210 12/31/2999 12/31/2999J0588 00259160501 12/31/2999 12/31/2999J0588 00259161001 12/31/2999 12/31/2999J0592 00409201232 12/31/2999 12/31/2999J0592 12496075701 12/31/2999 12/31/2999J0592 21695051510 12/31/2999 12/31/2999J0592 55390010010 12/31/2999 12/31/2999J0594 59148007090 12/31/2999 12/31/2999J0594 59148007091 12/31/2999 12/31/2999J0594 59148007191 12/31/2999 5/31/2011J0594 67286005308 12/31/2999 7/2/2009J0594 67286005408 12/31/2999 3/27/2012J0595 00054309036 12/31/2999 12/31/2999J0595 00074162701 12/31/2999 5/2/2011J0595 00143986410 12/31/2999 12/31/2999J0595 00143986710 12/31/2999 12/31/2999J0595 00378963943 12/31/2999 12/31/2999J0595 00409162301 12/31/2999 12/31/2999J0595 00409162349 12/31/2999 2/1/2009J0595 00409162601 12/31/2999 12/31/2999J0595 00409162602 12/31/2999 12/31/2999J0595 00409162649 12/31/2999 10/1/2008J0595 00409162651 12/31/2999 2/1/2009J0595 54569598800 12/31/2999 12/31/2999J0595 54868458300 12/31/2999 6/30/2012J0595 55390018301 12/31/2999 12/31/2999J0595 55390018401 12/31/2999 12/31/2999J0595 55390018402 12/31/2999 12/31/2999J0595 55390018510 12/31/2999 12/31/2999J0595 55390034110 12/31/2999 4/18/2013J0595 55390034210 12/31/2999 4/18/2013J0595 58016483301 12/31/2999 11/29/2012J0595 58016486801 12/31/2999 11/29/2012J0595 60505065800 12/31/2999 10/13/2010J0595 60505065900 12/31/2999 10/13/2010J0595 60505065901 12/31/2999 8/1/2008J0595 60505066000 12/31/2999 10/13/2010J0595 60505081301 12/31/2999 12/31/2999J0595 61703031706 12/31/2999 10/10/2000J0595 61703031745 12/31/2999 9/28/1998

Page 33: *This document is a compilation of NDC:HCPCS combinations

J0595 61703031845 12/31/2999 1/31/2008J0597 63833082502 12/31/2999 12/31/2999J0598 42227008105 12/31/2999 12/31/2999J0598 63833082502 12/31/2999 12/31/2999J0600 29336040010 6/30/2013 12/2/2011J0610 00186117102 12/31/2999 12/14/2012J0610 00517390025 12/31/2999 12/31/2999J0610 00517391025 12/31/2999 12/1/2011J0610 00517395025 12/31/2999 12/31/2999J0610 63323031110 12/31/2999 12/31/2999J0610 63323031150 12/31/2999 12/31/2999J0610 63323031161 12/31/2999 12/31/2999J0610 63323031163 12/31/2999 2/15/2013J0630 00078014923 12/31/2999 12/31/2999J0636 00143972805 12/31/2999 5/13/2011J0636 00517013225 12/31/2999 12/31/2999J0636 00703731104 12/31/2999 5/26/2011J0636 17478083101 12/31/2999 12/31/2999J0636 17478093101 12/31/2999 12/31/2999J0636 63323073101 12/31/2999 12/31/2999J0637 00006382210 12/31/2999 12/31/2999J0637 00006382310 12/31/2999 12/31/2999J0638 00078058261 12/31/2999 12/31/2999J0640 00703279301 12/31/2999 5/29/2013J0640 00703279701 12/31/2999 12/31/2999J0640 00703514001 12/31/2999 12/31/2999J0640 00703514501 12/31/2999 12/31/2999J0640 00703514591 12/31/2999 12/31/2999J0640 00904231560 12/31/2999 2/1/2000J0640 25021081310 12/31/2999 12/31/2999J0640 25021081430 12/31/2999 12/31/2999J0640 25021081530 12/31/2999 12/31/2999J0640 25021081567 12/31/2999 12/31/2999J0640 25021081630 12/31/2999 12/31/2999J0640 25021081667 12/31/2999 12/31/2999J0640 55390000901 12/31/2999 12/31/2999J0640 55390005110 12/31/2999 12/31/2999J0640 55390005210 12/31/2999 12/31/2999J0640 55390005301 12/31/2999 12/31/2999J0640 55390005401 12/31/2999 12/31/2999J0640 55390081810 12/31/2999 4/18/2013J0640 55390082401 12/31/2999 4/18/2013J0640 55390082501 12/31/2999 4/18/2013J0640 55390082601 12/31/2999 4/18/2013J0640 62701090030 12/31/2999 2/14/2002J0640 62701090099 12/31/2999 2/14/2002J0640 62701090125 12/31/2999 2/14/2002

Page 34: *This document is a compilation of NDC:HCPCS combinations

J0640 63323071050 12/31/2999 12/31/2999J0640 63323071100 12/31/2999 12/31/2999J0641 68152010100 12/31/2999 12/31/2999J0670 00186041201 12/31/2999 5/13/2009J0670 00186044014 12/31/2999 11/6/2000J0670 00409103630 12/31/2999 12/31/2999J0670 00409103850 12/31/2999 12/31/2999J0670 00409104130 12/31/2999 12/31/2999J0670 00409106720 12/31/2999 12/31/2999J0670 00409204750 12/31/2999 12/31/2999J0670 00409755101 12/31/2999 12/31/2999J0670 63323026030 12/31/2999 1/4/2013J0670 63323026037 12/31/2999 12/31/2999J0670 63323028350 12/31/2999 1/4/2013J0670 63323028357 12/31/2999 12/31/2999J0670 63323029330 12/31/2999 1/4/2013J0670 63323029337 12/31/2999 12/31/2999J0670 63323029420 12/31/2999 1/4/2013J0670 63323029427 12/31/2999 12/31/2999J0670 63323029650 12/31/2999 1/4/2013J0670 63323029657 12/31/2999 12/31/2999J0690 00143992390 12/31/2999 12/31/2999J0690 00143992490 12/31/2999 12/31/2999J0690 00143998303 12/31/2999 12/31/2999J0690 00247100101 12/31/2999 2/28/2003J0690 00247100110 12/31/2999 2/28/2003J0690 00264310311 12/31/2999 12/31/2999J0690 00264310511 12/31/2999 12/31/2999J0690 00338350341 12/31/2999 12/31/2999J0690 00409080501 12/31/2999 12/31/2999J0690 00409080601 12/31/2999 12/31/2999J0690 00409258501 12/31/2999 12/31/2999J0690 00781345070 12/31/2999 12/31/2999J0690 00781345095 12/31/2999 12/31/2999J0690 00781345170 12/31/2999 12/31/2999J0690 00781345196 12/31/2999 12/31/2999J0690 00781345246 12/31/2999 12/31/2999J0690 00781345295 12/31/2999 12/31/2999J0690 00781933746 12/31/2999 12/1/2011J0690 00781933795 9/30/2014 12/1/2011J0690 00781933895 12/31/2999 12/31/2999J0690 00781933985 12/31/2999 12/31/2999J0690 00781933996 6/30/2014 12/1/2011J0690 10019061010 12/31/2999 1/13/2012J0690 10019061110 12/31/2999 1/13/2012J0690 10019061211 12/31/2999 1/13/2012J0690 25021010010 12/31/2999 12/31/2999

Page 35: *This document is a compilation of NDC:HCPCS combinations

J0690 25021010110 12/31/2999 12/31/2999J0690 25021010299 12/31/2999 12/31/2999J0690 25021010399 12/31/2999 8/31/2011J0690 44567070625 12/31/2999 12/31/2999J0690 44567070725 12/31/2999 12/31/2999J0690 44567070810 12/31/2999 12/31/2999J0690 44567070910 12/31/2999 12/31/2999J0690 54868055900 12/31/2999 6/30/2011J0690 54868465100 12/31/2999 12/31/2999J0690 60505074904 12/31/2999 12/31/2999J0690 60505074905 12/31/2999 12/31/2999J0690 60505076900 12/31/2999 12/31/2999J0690 61553021148 12/31/2999 12/31/2999J0690 63323023610 12/31/2999 12/31/2999J0690 63323023710 12/31/2999 12/31/2999J0690 63323023861 12/31/2999 12/31/2999J0690 63323044666 12/31/2999 12/31/2999J0690 66288110001 12/31/2999 12/31/2999J0690 66288130001 12/31/2999 12/31/2999J0690 66860000103 12/31/2999 12/31/2999J0690 66860000203 12/31/2999 12/31/2999J0690 66860000302 12/31/2999 12/31/2999J0690 66860090203 12/31/2999 11/30/2007J0690 66860090302 12/31/2999 11/30/2007J0690 68330001425 12/31/2999 12/31/2999J0690 68330001525 12/31/2999 12/31/2999J0692 00264319311 12/31/2999 12/31/2999J0692 00264319511 12/31/2999 12/31/2999J0692 00338130141 12/31/2999 12/31/2999J0692 00338130148 12/31/2999 12/31/2999J0692 00409021701 12/31/2999 12/31/2999J0692 00409021801 12/31/2999 12/31/2999J0692 00409021901 12/31/2999 12/31/2999J0692 00409022001 12/31/2999 12/31/2999J0692 00781322280 12/31/2999 12/31/2999J0692 00781322295 12/31/2999 12/31/2999J0692 00781322391 12/31/2999 12/31/2999J0692 00781322395 12/31/2999 12/31/2999J0692 25021012120 12/31/2999 12/31/2999J0692 25021012250 12/31/2999 12/31/2999J0692 44567024010 12/31/2999 12/31/2999J0692 44567024110 12/31/2999 12/31/2999J0692 51479005310 12/31/2999 12/1/2008J0692 54569468300 12/31/2999 11/16/2002J0692 60505068100 12/31/2999 12/31/2999J0692 60505068104 12/31/2999 12/31/2999J0692 60505083400 12/31/2999 12/31/2999

Page 36: *This document is a compilation of NDC:HCPCS combinations

J0692 60505083404 12/31/2999 12/31/2999J0692 60505603004 12/31/2999 12/31/2999J0692 60505603104 12/31/2999 12/31/2999J0692 63323032620 12/31/2999 12/31/2999J0692 63323034020 12/31/2999 12/31/2999J0694 00143987610 12/31/2999 12/31/2999J0694 00143987725 12/31/2999 12/31/2999J0694 00143987825 12/31/2999 12/31/2999J0694 00264312311 12/31/2999 12/31/2999J0694 00264312511 12/31/2999 12/31/2999J0694 25021010910 12/31/2999 12/31/2999J0694 25021011020 12/31/2999 12/31/2999J0694 25021011199 12/31/2999 12/31/2999J0694 60505075905 12/31/2999 12/31/2999J0694 60505076005 12/31/2999 12/31/2999J0694 60505076104 12/31/2999 12/31/2999J0694 60505602505 12/31/2999 12/31/2999J0694 60505602605 12/31/2999 12/31/2999J0694 63323034125 12/31/2999 12/31/2999J0694 63323034225 12/31/2999 12/31/2999J0694 63323034361 12/31/2999 7/31/2012J0694 63323034366 12/31/2999 12/31/2999J0694 67457018901 12/31/2999 12/31/2999J0694 67457018902 12/31/2999 11/12/2010J0694 67457021650 12/31/2999 12/31/2999J0696 00004196301 12/31/2999 12/31/2999J0696 00004196302 12/31/2999 12/31/2999J0696 00004196401 12/31/2999 12/31/2999J0696 00004196404 12/31/2999 12/31/2999J0696 00143976801 12/31/2999 4/10/2012J0696 00143985625 12/31/2999 12/31/2999J0696 00143985725 12/31/2999 12/31/2999J0696 00143985825 12/31/2999 12/31/2999J0696 00143985925 12/31/2999 12/31/2999J0696 00264315311 12/31/2999 12/31/2999J0696 00264315511 12/31/2999 12/31/2999J0696 00338500241 12/31/2999 12/31/2999J0696 00338500341 12/31/2999 12/31/2999J0696 00409733201 12/31/2999 12/31/2999J0696 00409733304 12/31/2999 12/31/2999J0696 00409733349 12/31/2999 12/31/2999J0696 00409733410 12/31/2999 12/31/2999J0696 00409733503 12/31/2999 12/31/2999J0696 00409733604 12/31/2999 12/31/2999J0696 00409733649 12/31/2999 12/31/2999J0696 00409733701 12/31/2999 12/31/2999J0696 00409733801 12/31/2999 12/31/2999

Page 37: *This document is a compilation of NDC:HCPCS combinations

J0696 00517871110 12/31/2999 12/1/2011J0696 00517872210 12/31/2999 12/1/2011J0696 00517872510 12/31/2999 12/1/2011J0696 00517875010 12/31/2999 12/1/2011J0696 00703031503 1/31/2013 3/27/2012J0696 00703033501 4/30/2013 12/5/2011J0696 00703033504 4/30/2013 12/5/2011J0696 00703034601 1/31/2013 10/12/2012J0696 00703034603 1/31/2013 10/12/2012J0696 00703035901 1/31/2013 1/17/2013J0696 00781320685 12/31/2999 12/31/2999J0696 00781320695 12/31/2999 12/31/2999J0696 00781320785 12/31/2999 12/31/2999J0696 00781320795 12/31/2999 12/31/2999J0696 00781320885 12/31/2999 12/31/2999J0696 00781320895 12/31/2999 12/31/2999J0696 00781320990 12/31/2999 12/31/2999J0696 00781320995 12/31/2999 12/31/2999J0696 00781321046 12/31/2999 12/31/2999J0696 00781932685 12/31/2999 12/31/2999J0696 00781932695 12/31/2999 12/31/2999J0696 00781932795 12/31/2999 12/31/2999J0696 00781932885 12/31/2999 12/31/2999J0696 00781932895 12/31/2999 12/31/2999J0696 00781932990 12/31/2999 12/31/2999J0696 00781932995 12/31/2999 12/31/2999J0696 00781933046 12/31/2999 12/31/2999J0696 10019009801 12/31/2999 12/31/2999J0696 10019009871 12/31/2999 12/31/2999J0696 10019068571 12/31/2999 1/13/2012J0696 10019068671 12/31/2999 1/13/2012J0696 10019068771 12/31/2999 1/13/2012J0696 10019068804 12/31/2999 12/31/2999J0696 10019068827 12/31/2999 12/31/2999J0696 10019068905 12/31/2999 12/31/2999J0696 10019068911 12/31/2999 12/31/2999J0696 21695020210 12/31/2999 12/31/2999J0696 21695035210 12/31/2999 12/31/2999J0696 25021010410 12/31/2999 5/31/2010J0696 25021010510 12/31/2999 12/31/2999J0696 25021010610 12/31/2999 12/31/2999J0696 25021010720 12/31/2999 12/31/2999J0696 25021010899 12/31/2999 12/31/2999J0696 35356026701 12/31/2999 12/31/2999J0696 43063000210 12/31/2999 12/31/2999J0696 44567070025 12/31/2999 12/31/2999J0696 44567070125 12/31/2999 12/31/2999

Page 38: *This document is a compilation of NDC:HCPCS combinations

J0696 44567070225 12/31/2999 12/31/2999J0696 44567070301 12/31/2999 12/31/2999J0696 49999058601 12/31/2999 12/31/2999J0696 49999058610 12/31/2999 12/31/2999J0696 54569137700 12/31/2999 10/1/2008J0696 54569180201 12/31/2999 1/31/2003J0696 54569347700 12/31/2999 1/31/2003J0696 54569347900 12/31/2999 1/31/2003J0696 54569572000 12/31/2999 12/31/2999J0696 54569572100 12/31/2999 12/31/2999J0696 54569572200 12/31/2999 10/1/2012J0696 54569572300 12/31/2999 12/31/2999J0696 54569572400 12/31/2999 12/31/2999J0696 54569572500 12/31/2999 12/31/2999J0696 54868093400 12/31/2999 9/30/2008J0696 54868248801 12/31/2999 6/30/2011J0696 54868322100 12/31/2999 6/30/2010J0696 54868322101 12/31/2999 6/30/2010J0696 54868553300 12/31/2999 6/30/2012J0696 54868558900 12/31/2999 6/30/2012J0696 55390030910 12/31/2999 12/31/2999J0696 55390031010 12/31/2999 12/31/2999J0696 55390031110 12/31/2999 12/31/2999J0696 55390031210 12/31/2999 12/31/2999J0696 55390031601 12/31/2999 12/31/2999J0696 58016478601 12/31/2999 11/29/2012J0696 58016479001 12/31/2999 11/29/2012J0696 58016483401 12/31/2999 11/29/2012J0696 58016487301 12/31/2999 11/29/2012J0696 58016943801 12/31/2999 11/29/2012J0696 58016955101 12/31/2999 11/29/2012J0696 60505067905 12/31/2999 12/31/2999J0696 60505067908 12/31/2999 4/17/2013J0696 60505067909 12/31/2999 4/17/2013J0696 60505075000 12/31/2999 12/31/2999J0696 60505075004 12/31/2999 12/31/2999J0696 60505075100 12/31/2999 12/31/2999J0696 60505075104 12/31/2999 12/31/2999J0696 60505075200 12/31/2999 4/17/2013J0696 60505075204 12/31/2999 12/31/2999J0696 60505075300 12/31/2999 9/2/2011J0696 60505075304 12/31/2999 12/31/2999J0696 63323034410 12/31/2999 12/31/2999J0696 63323034510 12/31/2999 12/31/2999J0696 63323034610 12/31/2999 12/31/2999J0696 63323034720 12/31/2999 12/31/2999J0696 63323034861 12/31/2999 12/31/2999

Page 39: *This document is a compilation of NDC:HCPCS combinations

J0696 64679070101 12/31/2999 12/31/2999J0696 64679070102 12/31/2999 12/31/2999J0696 64679070103 12/31/2999 12/31/2999J0696 64679070201 12/31/2999 12/31/2999J0696 64679070202 12/31/2999 12/31/2999J0696 64679070301 12/31/2999 12/31/2999J0696 64679070302 12/31/2999 12/31/2999J0696 64679098301 12/31/2999 12/31/2999J0696 64679098302 12/31/2999 12/31/2999J0696 66860007102 12/31/2999 12/31/2999J0696 66860007202 12/31/2999 12/31/2999J0696 66860007302 12/31/2999 12/31/2999J0696 66860007402 12/31/2999 12/31/2999J0696 68180061101 12/31/2999 12/31/2999J0696 68180061110 12/31/2999 12/31/2999J0696 68180062201 12/31/2999 12/31/2999J0696 68180062210 12/31/2999 12/31/2999J0696 68180063301 12/31/2999 12/31/2999J0696 68180063310 12/31/2999 12/31/2999J0696 68180064401 12/31/2999 12/31/2999J0696 68180064410 12/31/2999 12/31/2999J0696 68330000201 12/31/2999 10/31/2009J0696 68330000210 12/31/2999 10/31/2009J0696 68330000301 12/31/2999 10/31/2009J0696 68330000310 12/31/2999 10/31/2009J0696 68330000401 12/31/2999 10/31/2009J0696 68330000410 12/31/2999 10/31/2009J0696 68330000501 12/31/2999 10/31/2009J0696 68330000601 12/31/2999 10/31/2009J0697 00143997603 12/31/2999 12/31/2999J0697 00143997722 12/31/2999 12/31/2999J0697 00143997922 12/31/2999 12/31/2999J0697 00143997990 12/31/2999 4/26/2011J0697 00173035210 12/31/2999 12/31/2999J0697 00173035410 12/31/2999 12/31/2999J0697 00173040000 12/31/2999 4/5/2013J0697 00173042400 12/31/2999 6/28/2013J0697 00173042500 12/31/2999 12/31/2999J0697 00173043600 12/31/2999 12/31/2999J0697 00173043700 12/31/2999 5/3/2013J0697 00264311211 12/31/2999 12/31/2999J0697 00264311411 12/31/2999 12/31/2999J0697 00409080201 12/31/2999 12/31/2999J0697 00409080301 12/31/2999 12/31/2999J0697 00781920570 12/31/2999 3/1/2009J0697 00781920680 12/31/2999 3/1/2009J0697 00781920746 12/31/2999 3/1/2009

Page 40: *This document is a compilation of NDC:HCPCS combinations

J0697 10019062010 12/31/2999 1/13/2012J0697 10019062120 12/31/2999 1/13/2012J0697 10019062205 12/31/2999 1/13/2012J0697 10019062211 12/31/2999 1/13/2012J0697 24987035210 12/31/2999 12/31/2999J0697 24987035410 12/31/2999 12/31/2999J0697 24987040000 12/31/2999 12/31/2999J0697 24987042500 12/31/2999 12/31/2999J0697 24987043700 12/31/2999 12/31/2999J0697 25021011810 12/31/2999 12/31/2999J0697 25021011920 12/31/2999 12/31/2999J0697 25021012059 12/31/2999 12/31/2999J0697 63323035245 12/31/2999 12/31/2999J0697 63323035345 12/31/2999 12/31/2999J0697 63323035445 12/31/2999 12/31/2999J0697 66288207501 12/31/2999 12/31/2999J0697 66860003003 12/31/2999 12/31/2999J0697 66860003103 12/31/2999 12/31/2999J0697 66860003202 12/31/2999 12/31/2999J0697 66860073003 12/31/2999 10/1/2009J0697 66860073103 12/31/2999 10/1/2009J0698 00039001710 12/31/2999 12/31/2999J0698 00039001810 12/31/2999 12/31/2999J0698 00039001861 12/31/2999 5/2/2011J0698 00039001910 12/31/2999 12/31/2999J0698 00039002001 12/31/2999 12/31/2999J0698 00039002325 12/31/2999 12/31/2999J0698 00039002425 12/31/2999 12/31/2999J0698 00039003705 12/31/2999 10/22/2008J0698 00039003805 12/31/2999 10/22/2008J0698 00143993003 12/31/2999 12/31/2999J0698 00143993010 12/31/2999 12/31/2999J0698 00143993122 12/31/2999 12/31/2999J0698 00143993125 12/31/2999 12/31/2999J0698 00143993322 12/31/2999 12/31/2999J0698 00143993325 12/31/2999 12/31/2999J0698 00143993591 12/31/2999 12/31/2999J0698 10019068015 12/31/2999 1/13/2012J0698 10019068115 12/31/2999 1/13/2012J0698 10019068215 12/31/2999 1/13/2012J0698 54569248400 12/31/2999 1/31/2003J0698 54868342900 12/31/2999 6/30/2002J0698 54868342901 12/31/2999 6/30/2002J0698 63323033115 12/31/2999 7/27/2011J0698 63323033215 12/31/2999 7/27/2011J0698 63323033361 12/31/2999 7/27/2011J0698 63323033461 12/31/2999 7/27/2011

Page 41: *This document is a compilation of NDC:HCPCS combinations

J0698 63323033510 12/31/2999 7/27/2011J0698 66860004102 12/31/2999 12/31/2999J0698 66860004203 12/31/2999 12/31/2999J0698 66860004303 12/31/2999 12/31/2999J0698 66860004401 12/31/2999 12/31/2999J0702 00085056605 12/31/2999 12/31/2999J0702 00517072001 12/31/2999 12/31/2999J0702 35356008401 12/31/2999 12/31/2999J0702 54868020600 12/31/2999 6/30/2012J0702 58016919101 12/31/2999 11/29/2012J0706 00517002010 12/31/2999 12/31/2999J0706 00574015210 12/31/2999 12/31/2999J0706 00574015280 12/31/2999 12/31/2999J0706 00574082301 12/31/2999 12/31/2999J0706 00574082381 12/31/2999 12/31/2999J0706 25021060103 12/31/2999 12/31/2999J0706 47335028940 12/31/2999 12/31/2999J0706 47335029044 12/31/2999 12/31/2999J0706 55390035703 12/31/2999 12/31/2999J0706 55390035803 12/31/2999 12/31/2999J0706 63323040603 12/31/2999 12/31/2999J0706 63323040703 12/31/2999 12/31/2999J0712 00456040010 12/31/2999 12/31/2999J0712 00456060010 12/31/2999 12/31/2999J0713 00173037710 12/31/2999 12/17/2012J0713 00173037810 12/31/2999 12/31/2999J0713 00173037934 12/31/2999 12/31/2999J0713 00173038237 12/31/2999 6/19/2013J0713 00173041200 12/31/2999 12/31/2999J0713 00173041300 12/31/2999 12/31/2999J0713 00173043400 12/31/2999 12/31/2999J0713 00173043500 12/31/2999 12/31/2999J0713 00264314311 12/31/2999 12/31/2999J0713 00264314511 12/31/2999 12/31/2999J0713 00409508216 12/31/2999 12/31/2999J0713 00409508252 12/31/2999 12/31/2999J0713 00409508411 12/31/2999 12/31/2999J0713 00409508451 12/31/2999 12/31/2999J0713 00409508611 12/31/2999 12/31/2999J0713 00409508651 12/31/2999 12/31/2999J0713 00409509216 12/31/2999 12/31/2999J0713 00409509252 12/31/2999 12/31/2999J0713 00409509311 12/31/2999 12/31/2999J0713 00409509351 12/31/2999 12/31/2999J0713 00781317780 12/31/2999 12/31/2999J0713 00781317796 12/31/2999 12/31/2999J0713 00781317891 12/31/2999 12/31/2999

Page 42: *This document is a compilation of NDC:HCPCS combinations

J0713 00781317895 12/31/2999 12/31/2999J0713 00781317986 12/31/2999 12/31/2999J0713 10019069127 12/31/2999 1/13/2012J0713 10019069250 12/31/2999 1/13/2012J0713 10019069311 12/31/2999 1/13/2012J0713 24987037710 12/31/2999 12/31/2999J0713 24987037810 12/31/2999 12/31/2999J0713 24987037934 12/31/2999 12/31/2999J0713 24987038237 12/31/2999 12/31/2999J0713 24987041200 12/31/2999 12/31/2999J0713 24987041300 12/31/2999 12/31/2999J0713 24987043400 12/31/2999 12/31/2999J0713 24987043500 12/31/2999 12/31/2999J0713 25021012720 12/31/2999 12/31/2999J0713 25021012850 12/31/2999 12/31/2999J0713 25021012999 12/31/2999 12/31/2999J0713 44567023525 12/31/2999 12/31/2999J0713 44567023610 12/31/2999 12/31/2999J0713 44567023706 12/31/2999 12/31/2999J0713 54569468200 12/31/2999 11/16/2002J0713 66288510001 12/31/2999 1/1/2007J0717 50474070062 12/31/2999 12/31/2999J0717 50474071079 12/31/2999 12/31/2999J0717 50474071081 12/31/2999 12/31/2999J0718 50474070062 12/31/2999 12/31/2999J0718 50474071079 12/31/2999 12/31/2999J0718 50474071081 12/31/2999 12/31/2999J0720 63323001115 12/31/2999 12/31/2999J0725 00052031510 12/31/2999 12/31/2999J0725 54868412100 12/31/2999 6/30/2008J0725 54868499700 12/31/2999 12/31/2999J0725 55566150101 12/31/2999 12/31/2999J0725 63323002510 12/31/2999 12/31/2999J0735 00143972301 12/31/2999 12/31/2999J0735 00143972401 12/31/2999 12/31/2999J0735 00517073001 12/31/2999 12/31/2999J0735 00517073101 12/31/2999 12/31/2999J0735 63323040510 12/31/2999 12/31/2999J0735 63323042710 12/31/2999 12/31/2999J0735 67457021810 12/31/2999 12/31/2999J0735 67457021910 12/31/2999 12/31/2999J0740 23155021631 12/31/2999 12/31/2999J0740 54868397900 12/31/2999 6/30/2011J0740 61958010101 12/31/2999 12/31/2999J0740 67457021005 12/31/2999 12/31/2999J0743 00006351458 12/31/2999 12/31/2999J0743 00006351659 12/31/2999 12/31/2999

Page 43: *This document is a compilation of NDC:HCPCS combinations

J0743 00006355158 12/31/2999 12/31/2999J0743 00006355259 12/31/2999 12/31/2999J0743 00006358275 12/31/2999 4/30/2011J0743 00409350701 12/31/2999 12/31/2999J0743 00409350710 12/31/2999 12/31/2999J0743 00409350801 12/31/2999 12/31/2999J0743 00409350810 12/31/2999 12/31/2999J0743 63323032220 12/31/2999 12/31/2999J0743 63323032225 12/31/2999 12/31/2999J0743 63323034920 12/31/2999 12/31/2999J0743 63323034925 12/31/2999 12/31/2999J0744 00085176303 12/31/2999 8/8/2009J0744 00409476586 12/31/2999 12/31/2999J0744 00409477702 12/31/2999 12/31/2999J0744 00409477723 12/31/2999 12/31/2999J0744 00409477749 12/31/2999 12/31/2999J0744 00409477750 12/31/2999 12/31/2999J0744 00409477886 12/31/2999 12/31/2999J0744 00703096936 12/31/2999 2/25/2011J0744 00781323909 12/31/2999 12/31/2999J0744 00781324009 12/31/2999 12/31/2999J0744 21695091440 12/31/2999 12/31/2999J0744 25021011482 12/31/2999 12/31/2999J0744 25021011487 12/31/2999 12/31/2999J0744 36000000824 12/31/2999 12/31/2999J0744 36000000924 12/31/2999 12/31/2999J0744 36000001001 12/31/2999 12/31/2999J0744 36000001101 12/31/2999 12/31/2999J0744 50419075901 12/31/2999 12/31/2999J0744 54868454700 12/31/2999 4/1/2009J0744 55390019701 12/31/2999 5/2/2011J0744 55390019801 12/31/2999 5/2/2011J0744 55390019901 12/31/2999 5/2/2011J0745 00074109712 12/31/2999 7/19/2011J0745 00074110212 12/31/2999 7/19/2011J0745 00409109732 12/31/2999 3/1/2010J0745 00409110232 12/31/2999 7/1/2010J0770 00574085801 12/31/2999 12/31/2999J0770 39822061501 12/31/2999 12/31/2999J0770 39822061502 12/31/2999 12/31/2999J0770 42023010701 12/31/2999 12/31/2999J0770 42023010706 12/31/2999 12/31/2999J0770 42023013101 12/31/2999 12/31/2999J0770 42023013106 12/31/2999 12/31/2999J0770 54868561200 12/31/2999 6/30/2011J0770 63323039306 12/31/2999 12/31/2999J0775 66887000301 12/31/2999 12/31/2999

Page 44: *This document is a compilation of NDC:HCPCS combinations

J0780 54569237900 12/31/2999 1/31/2003J0780 54868026100 12/31/2999 6/30/2012J0780 54868413700 12/31/2999 3/18/2004J0780 55390007701 12/31/2999 12/31/2999J0780 55390007710 12/31/2999 12/31/2999J0795 55566030201 12/31/2999 12/31/2999J0800 63004773101 12/31/2999 12/31/2999J0800 63004871001 12/31/2999 12/31/2999J0833 00781305295 12/31/2999 12/31/2999J0834 00548590000 12/31/2999 12/31/2999J0834 00781344095 12/31/2999 12/31/2999J0834 10139090502 2/28/2013 9/13/2012J0834 10139090510 2/28/2013 9/13/2012J0834 67457022702 12/31/2999 12/31/2999J0834 67457025702 12/31/2999 12/31/2999J0840 00281033010 6/30/2013 10/1/2010J0840 50633011012 12/31/2999 12/31/2999J0850 44206053211 12/31/2999 12/31/2999J0850 44206310101 12/31/2999 6/14/2011J0850 44206310110 6/28/2013 5/27/2009J0878 67919001101 12/31/2999 12/31/2999J0881 54868542800 12/31/2999 12/31/2999J0881 54868542900 12/31/2999 12/31/2999J0881 54868586700 12/31/2999 12/31/2999J0881 55513000201 12/31/2999 12/31/2999J0881 55513000204 12/31/2999 12/31/2999J0881 55513000301 12/31/2999 12/31/2999J0881 55513000304 12/31/2999 12/31/2999J0881 55513000401 12/31/2999 12/31/2999J0881 55513000404 12/31/2999 12/31/2999J0881 55513000501 12/31/2999 12/31/2999J0881 55513000504 12/31/2999 12/31/2999J0881 55513000601 12/31/2999 12/31/2999J0881 55513002101 12/31/2999 12/31/2999J0881 55513002104 12/31/2999 12/31/2999J0881 55513002301 12/31/2999 12/31/2999J0881 55513002304 12/31/2999 12/31/2999J0881 55513002501 12/31/2999 12/31/2999J0881 55513002504 12/31/2999 12/31/2999J0881 55513002701 12/31/2999 12/31/2999J0881 55513002704 12/31/2999 12/31/2999J0881 55513002801 12/31/2999 12/31/2999J0881 55513003201 12/31/2999 12/31/2999J0881 55513005301 12/31/2999 12/31/2999J0881 55513005304 12/31/2999 12/31/2999J0881 55513005701 12/31/2999 12/31/2999J0881 55513005704 12/31/2999 12/31/2999

Page 45: *This document is a compilation of NDC:HCPCS combinations

J0881 55513011001 12/31/2999 12/31/2999J0881 55513011101 12/31/2999 12/31/2999J0882 54868542800 12/31/2999 12/31/2999J0882 54868542900 12/31/2999 12/31/2999J0882 54868586700 12/31/2999 12/31/2999J0882 55513000201 12/31/2999 12/31/2999J0882 55513000204 12/31/2999 12/31/2999J0882 55513000301 12/31/2999 12/31/2999J0882 55513000304 12/31/2999 12/31/2999J0882 55513000401 12/31/2999 12/31/2999J0882 55513000404 12/31/2999 12/31/2999J0882 55513000501 12/31/2999 12/31/2999J0882 55513000504 12/31/2999 12/31/2999J0882 55513000601 12/31/2999 12/31/2999J0882 55513002101 12/31/2999 12/31/2999J0882 55513002104 12/31/2999 12/31/2999J0882 55513002301 12/31/2999 12/31/2999J0882 55513002304 12/31/2999 12/31/2999J0882 55513002501 12/31/2999 12/31/2999J0882 55513002504 12/31/2999 12/31/2999J0882 55513002701 12/31/2999 12/31/2999J0882 55513002704 12/31/2999 12/31/2999J0882 55513002801 12/31/2999 12/31/2999J0882 55513003201 12/31/2999 12/31/2999J0882 55513005301 12/31/2999 12/31/2999J0882 55513005304 12/31/2999 12/31/2999J0882 55513005701 12/31/2999 12/31/2999J0882 55513005704 12/31/2999 12/31/2999J0882 55513011001 12/31/2999 12/31/2999J0882 55513011101 12/31/2999 12/31/2999J0885 54569313700 12/31/2999 1/31/2003J0885 54868252300 12/31/2999 5/11/2012J0885 54868252301 12/31/2999 12/31/2999J0885 54868567301 12/31/2999 5/11/2012J0885 54868580200 12/31/2999 12/31/2999J0885 55513012601 12/31/2999 12/31/2999J0885 55513012610 12/31/2999 12/31/2999J0885 55513014401 12/31/2999 12/31/2999J0885 55513014410 12/31/2999 12/31/2999J0885 55513014801 12/31/2999 12/31/2999J0885 55513014810 12/31/2999 12/31/2999J0885 55513026701 12/31/2999 12/31/2999J0885 55513026710 12/31/2999 12/31/2999J0885 55513028301 12/31/2999 12/31/2999J0885 55513028310 12/31/2999 12/31/2999J0885 55513047801 12/31/2999 12/31/2999J0885 55513047810 12/31/2999 12/31/2999

Page 46: *This document is a compilation of NDC:HCPCS combinations

J0885 59676030201 12/31/2999 12/31/2999J0885 59676030202 12/31/2999 12/31/2999J0885 59676030301 12/31/2999 12/31/2999J0885 59676030302 12/31/2999 12/31/2999J0885 59676030401 12/31/2999 12/31/2999J0885 59676030402 12/31/2999 12/31/2999J0885 59676031000 12/31/2999 12/31/2999J0885 59676031001 12/31/2999 12/31/2999J0885 59676031002 12/31/2999 12/31/2999J0885 59676031204 12/31/2999 12/31/2999J0885 59676032004 12/31/2999 12/31/2999J0885 59676034001 12/31/2999 12/31/2999J0886 54569313700 12/31/2999 1/31/2003J0886 54868252300 12/31/2999 5/11/2012J0886 54868252301 12/31/2999 12/31/2999J0886 54868567301 12/31/2999 5/11/2012J0886 54868580200 12/31/2999 12/31/2999J0886 55513012601 12/31/2999 12/31/2999J0886 55513012610 12/31/2999 12/31/2999J0886 55513014401 12/31/2999 12/31/2999J0886 55513014410 12/31/2999 12/31/2999J0886 55513014801 12/31/2999 12/31/2999J0886 55513014810 12/31/2999 12/31/2999J0886 55513026701 12/31/2999 12/31/2999J0886 55513026710 12/31/2999 12/31/2999J0886 55513028301 12/31/2999 12/31/2999J0886 55513028310 12/31/2999 12/31/2999J0886 55513047801 12/31/2999 12/31/2999J0886 55513047810 12/31/2999 12/31/2999J0886 59676030201 12/31/2999 12/31/2999J0886 59676030202 12/31/2999 12/31/2999J0886 59676030301 12/31/2999 12/31/2999J0886 59676030302 12/31/2999 12/31/2999J0886 59676030401 12/31/2999 12/31/2999J0886 59676030402 12/31/2999 12/31/2999J0886 59676031000 12/31/2999 12/31/2999J0886 59676031001 12/31/2999 12/31/2999J0886 59676031002 12/31/2999 12/31/2999J0886 59676031204 12/31/2999 12/31/2999J0886 59676032004 12/31/2999 12/31/2999J0886 59676034001 12/31/2999 12/31/2999J0890 64764061010 12/31/2999 2/25/2013J0890 64764062020 12/31/2999 2/25/2013J0894 55111055610 12/31/2999 12/31/2999J0894 62856060001 12/31/2999 12/31/2999J0895 00078034751 12/31/2999 12/31/2999J0895 00078046791 12/31/2999 12/31/2999

Page 47: *This document is a compilation of NDC:HCPCS combinations

J0895 00409233610 12/31/2999 5/2/2011J0895 00409233725 12/31/2999 12/31/2999J0895 00555113111 12/31/2999 12/31/2999J0895 00555113212 3/31/2014 2/5/2013J0895 55390026310 12/31/2999 12/31/2999J0895 63323059710 12/31/2999 12/31/2999J0895 63323059930 12/31/2999 12/31/2999J0897 55513071001 12/31/2999 12/31/2999J0897 55513073001 12/31/2999 12/31/2999J1000 00009027101 12/31/2999 12/31/2999J1000 54868172900 12/31/2999 12/31/2999J1020 00009027401 12/31/2999 12/31/2999J1020 00009028002 12/31/2999 12/31/2999J1020 00009028003 12/31/2999 12/31/2999J1020 00009028051 12/31/2999 12/31/2999J1020 00009028052 12/31/2999 12/31/2999J1020 00009030602 12/31/2999 12/31/2999J1020 00009030612 12/31/2999 12/31/2999J1020 00009307301 12/31/2999 12/31/2999J1020 00009307303 12/31/2999 12/31/2999J1020 00009307322 12/31/2999 12/31/2999J1020 00009307323 12/31/2999 12/31/2999J1020 00009347501 12/31/2999 12/31/2999J1020 00009347503 12/31/2999 12/31/2999J1020 00009347522 12/31/2999 12/31/2999J1020 00009347523 12/31/2999 12/31/2999J1020 00703003101 12/31/2999 12/31/2999J1020 00703003104 12/31/2999 12/31/2999J1020 00703004301 12/31/2999 12/31/2999J1020 00703004501 12/31/2999 12/31/2999J1020 00703005101 12/31/2999 12/31/2999J1020 00703005104 12/31/2999 12/31/2999J1020 00703006301 12/31/2999 12/31/2999J1020 00781313171 12/31/2999 12/31/2999J1020 00781313195 12/31/2999 12/31/2999J1020 00781313271 12/31/2999 12/31/2999J1020 00781313295 12/31/2999 12/31/2999J1020 00781313670 12/31/2999 12/31/2999J1020 00781313775 12/31/2999 12/31/2999J1020 35356008301 12/31/2999 12/31/2999J1020 35356017805 12/31/2999 12/31/2999J1020 35356048310 12/31/2999 12/31/2999J1020 35356048405 12/31/2999 12/31/2999J1020 51927133200 12/31/2999 12/31/2999J1020 54868118500 12/31/2999 6/30/2012J1020 54868118501 12/31/2999 6/30/2012J1020 54868389600 12/31/2999 12/31/2999

Page 48: *This document is a compilation of NDC:HCPCS combinations

J1020 54868389601 12/31/2999 6/30/2011J1020 54868389602 12/31/2999 6/30/2011J1020 58016489301 12/31/2999 11/29/2012J1020 58016993401 12/31/2999 11/29/2012J1030 00009027401 12/31/2999 12/31/2999J1030 00009028002 12/31/2999 12/31/2999J1030 00009028003 12/31/2999 12/31/2999J1030 00009028051 12/31/2999 12/31/2999J1030 00009028052 12/31/2999 12/31/2999J1030 00009030602 12/31/2999 12/31/2999J1030 00009030612 12/31/2999 12/31/2999J1030 00009307301 12/31/2999 12/31/2999J1030 00009307303 12/31/2999 12/31/2999J1030 00009307322 12/31/2999 12/31/2999J1030 00009307323 12/31/2999 12/31/2999J1030 00009347501 12/31/2999 12/31/2999J1030 00009347503 12/31/2999 12/31/2999J1030 00009347522 12/31/2999 12/31/2999J1030 00009347523 12/31/2999 12/31/2999J1030 00703003101 12/31/2999 12/31/2999J1030 00703003104 12/31/2999 12/31/2999J1030 00703004301 12/31/2999 12/31/2999J1030 00703004501 12/31/2999 12/31/2999J1030 00703005101 12/31/2999 12/31/2999J1030 00703005104 12/31/2999 12/31/2999J1030 00703006301 12/31/2999 12/31/2999J1030 00781313171 12/31/2999 12/31/2999J1030 00781313195 12/31/2999 12/31/2999J1030 00781313670 12/31/2999 12/31/2999J1030 00781313775 12/31/2999 12/31/2999J1030 35356008301 12/31/2999 12/31/2999J1030 35356017805 12/31/2999 12/31/2999J1030 35356048310 12/31/2999 12/31/2999J1030 35356048405 12/31/2999 12/31/2999J1030 54569190101 12/31/2999 1/31/2003J1030 54569221300 12/31/2999 1/31/2003J1030 54569394600 12/31/2999 1/31/2003J1030 54569426500 12/31/2999 1/31/2003J1030 54868118500 12/31/2999 6/30/2012J1030 54868118501 12/31/2999 6/30/2012J1030 54868389600 12/31/2999 12/31/2999J1030 54868389601 12/31/2999 6/30/2011J1030 54868389602 12/31/2999 6/30/2011J1030 58016489301 12/31/2999 11/29/2012J1030 58016993401 12/31/2999 11/29/2012J1040 00009027401 12/31/2999 12/31/2999J1040 00009028002 12/31/2999 12/31/2999

Page 49: *This document is a compilation of NDC:HCPCS combinations

J1040 00009028003 12/31/2999 12/31/2999J1040 00009028051 12/31/2999 12/31/2999J1040 00009028052 12/31/2999 12/31/2999J1040 00009030602 12/31/2999 12/31/2999J1040 00009030612 12/31/2999 12/31/2999J1040 00009307301 12/31/2999 12/31/2999J1040 00009307303 12/31/2999 12/31/2999J1040 00009307322 12/31/2999 12/31/2999J1040 00009307323 12/31/2999 12/31/2999J1040 00009347501 12/31/2999 12/31/2999J1040 00009347503 12/31/2999 12/31/2999J1040 00009347522 12/31/2999 12/31/2999J1040 00009347523 12/31/2999 12/31/2999J1040 00703003101 12/31/2999 12/31/2999J1040 00703003104 12/31/2999 12/31/2999J1040 00703004301 12/31/2999 12/31/2999J1040 00703004501 12/31/2999 12/31/2999J1040 00703005101 12/31/2999 12/31/2999J1040 00703005104 12/31/2999 12/31/2999J1040 00703006301 12/31/2999 12/31/2999J1040 00781313171 12/31/2999 12/31/2999J1040 00781313195 12/31/2999 12/31/2999J1040 00781313295 12/31/2999 12/31/2999J1040 00781313670 12/31/2999 12/31/2999J1040 00781313775 12/31/2999 12/31/2999J1040 35356008301 12/31/2999 12/31/2999J1040 35356017805 12/31/2999 12/31/2999J1040 35356048310 12/31/2999 12/31/2999J1040 35356048405 12/31/2999 12/31/2999J1040 54569223200 12/31/2999 1/31/2003J1040 54569337400 12/31/2999 1/31/2003J1040 54868118500 12/31/2999 6/30/2012J1040 54868118501 12/31/2999 6/30/2012J1040 54868389600 12/31/2999 12/31/2999J1040 54868389601 12/31/2999 6/30/2011J1040 54868389602 12/31/2999 6/30/2011J1040 58016489301 12/31/2999 11/29/2012J1040 58016993401 12/31/2999 11/29/2012J1050 00009062601 12/31/2999 12/31/2999J1050 00009074630 12/31/2999 12/31/2999J1050 00009074635 12/31/2999 12/31/2999J1050 00009737611 12/31/2999 12/31/2999J1050 00703680101 12/31/2999 12/31/2999J1050 00703680104 12/31/2999 12/31/2999J1050 54569490400 12/31/2999 10/31/2011J1050 54569552700 12/31/2999 12/31/2999J1050 54868334801 12/31/2999 6/30/2011

Page 50: *This document is a compilation of NDC:HCPCS combinations

J1050 54868361300 12/31/2999 12/31/2999J1050 54868410000 12/31/2999 6/30/2011J1050 54868410001 12/31/2999 6/30/2011J1050 54868525700 12/31/2999 12/31/2999J1050 55045350501 12/31/2999 10/7/2009J1050 59762453701 12/31/2999 12/31/2999J1050 59762453702 12/31/2999 12/31/2999J1050 59762453801 11/30/2013 12/31/2999J1050 59762453802 12/31/2999 12/31/2999J1051 00009062601 12/31/2999 12/31/2999J1051 00009074630 12/31/2999 12/31/2999J1051 00009074635 12/31/2999 12/31/2999J1051 00009737604 4/30/2013 10/31/2011J1051 00703680101 12/31/2999 12/31/2999J1051 54569552700 12/31/2999 12/31/2999J1051 54868334801 12/31/2999 6/30/2011J1051 54868361300 12/31/2999 12/31/2999J1051 54868410000 12/31/2999 6/30/2011J1051 54868410001 12/31/2999 6/30/2011J1051 54868525700 12/31/2999 12/31/2999J1051 59762453701 12/31/2999 12/31/2999J1051 59762453702 12/31/2999 12/31/2999J1051 59762453801 11/30/2013 12/31/2999J1055 00009074630 12/31/2999 12/31/2999J1055 00009074635 12/31/2999 12/31/2999J1055 00009470913 12/31/2999 12/31/2999J1055 00009737604 4/30/2013 10/31/2011J1055 00009737607 12/31/2014 6/29/2012J1055 00009737611 12/31/2999 12/31/2999J1055 00703680101 12/31/2999 12/31/2999J1055 00703680104 12/31/2999 12/31/2999J1055 54569552700 12/31/2999 12/31/2999J1055 54868361300 12/31/2999 12/31/2999J1055 54868410000 12/31/2999 6/30/2011J1055 54868410001 12/31/2999 6/30/2011J1055 54868525700 12/31/2999 12/31/2999J1055 59762453701 12/31/2999 12/31/2999J1055 59762453702 12/31/2999 12/31/2999J1055 59762453801 11/30/2013 12/31/2999J1055 59762453802 12/31/2999 12/31/2999J1055 59762453809 12/31/2999 9/17/2012J1060 00009034702 12/31/2999 12/31/2999J1060 00009041701 12/31/2999 12/31/2999J1060 00009041702 12/31/2999 12/31/2999J1060 00574082001 12/31/2999 12/31/2999J1060 00574082010 12/31/2999 12/31/2999J1060 00591322379 12/31/2999 12/31/2999

Page 51: *This document is a compilation of NDC:HCPCS combinations

J1060 00781307370 12/31/2999 12/31/2999J1060 00781307470 12/31/2999 12/31/2999J1060 00781307471 12/31/2999 12/31/2999J1060 35356005810 12/31/2999 12/31/2999J1060 54868021600 12/31/2999 12/31/2999J1060 54868021601 12/31/2999 6/30/2012J1060 54868079600 12/31/2999 6/30/2011J1060 54868361800 12/31/2999 12/31/2999J1060 54868361801 12/31/2999 12/31/2999J1070 00009034702 12/31/2999 12/31/2999J1070 00781307370 12/31/2999 12/31/2999J1070 35356005810 12/31/2999 12/31/2999J1070 54868079600 12/31/2999 6/30/2011J1070 62756001740 12/31/2999 12/31/2999J1080 00009041701 12/31/2999 12/31/2999J1080 00009041702 12/31/2999 12/31/2999J1080 00143972601 12/31/2999 12/31/2999J1080 00574082001 12/31/2999 12/31/2999J1080 00574082010 12/31/2999 12/31/2999J1080 00591322379 12/31/2999 12/31/2999J1080 00781307470 12/31/2999 12/31/2999J1080 00781307471 12/31/2999 12/31/2999J1080 54569141100 12/31/2999 1/31/2003J1080 54569213100 12/31/2999 12/31/2999J1080 54868021600 12/31/2999 12/31/2999J1080 54868361800 12/31/2999 12/31/2999J1080 54868361801 12/31/2999 12/31/2999J1080 55045302902 12/31/2999 10/7/2009J1080 62756001540 12/31/2999 12/31/2999J1080 62756001640 12/31/2999 12/31/2999J1094 00517490525 12/31/2999 12/31/2999J1094 00517493025 12/31/2999 12/31/2999J1094 00641036725 12/31/2999 12/31/2999J1100 00069017702 12/31/2999 11/5/2013J1100 00069017802 12/31/2999 11/5/2013J1100 00069017902 12/31/2999 11/5/2013J1100 00069019202 12/31/2999 11/5/2013J1100 00069454102 12/31/2999 12/31/2999J1100 00069454302 12/31/2999 12/31/2999J1100 00069454502 12/31/2999 12/31/2999J1100 00069454702 12/31/2999 12/31/2999J1100 00517490125 12/31/2999 12/31/2999J1100 00517490525 12/31/2999 12/31/2999J1100 00517493025 12/31/2999 12/31/2999J1100 00641036721 12/31/2999 12/31/2999J1100 00641036725 12/31/2999 12/31/2999J1100 21695084830 12/31/2999 12/31/2999

Page 52: *This document is a compilation of NDC:HCPCS combinations

J1100 49999043425 12/31/2999 4/11/2012J1100 54569304000 12/31/2999 1/31/2003J1100 54569464800 12/31/2999 1/31/2003J1100 54569472800 12/31/2999 1/31/2003J1100 54868087100 12/31/2999 6/30/2012J1100 54868087106 12/31/2999 6/30/2012J1100 63323016501 12/31/2999 12/31/2999J1100 63323016505 12/31/2999 12/31/2999J1100 63323016530 12/31/2999 12/31/2999J1100 63323050601 12/31/2999 12/31/2999J1100 63323051610 12/31/2999 12/31/2999J1110 00574085005 12/31/2999 12/31/2999J1110 00574085010 12/31/2999 12/31/2999J1110 55390001310 12/31/2999 12/31/2999J1110 66490004101 12/31/2999 12/31/2999J1120 25021081710 12/31/2999 12/31/2999J1120 39822019001 12/31/2999 12/31/2999J1120 39822019007 12/31/2999 12/31/2999J1120 39822019109 12/31/2999 12/31/2999J1120 55390046001 12/31/2999 12/31/2999J1160 00173026010 12/31/2999 12/31/2999J1160 00173026210 12/31/2999 4/23/2013J1160 00409216931 12/31/2999 12/31/2999J1160 00641141031 12/31/2999 12/31/2999J1160 00641141035 12/31/2999 12/31/2999J1160 00781305995 12/31/2999 12/31/2999J1160 24987026010 12/31/2999 12/31/2999J1160 24987026210 12/31/2999 12/31/2999J1160 66860008002 12/31/2999 8/11/2009J1162 00173023044 1/31/2013 1/24/2011J1162 50633012011 12/31/2999 12/31/2999J1165 00143988125 12/31/2999 6/10/2011J1165 00143988225 12/31/2999 6/10/2011J1165 00409131701 12/31/2999 12/31/2999J1165 00409131702 12/31/2999 12/31/2999J1165 00409184432 12/31/2999 12/31/2999J1165 00641049321 12/31/2999 12/31/2999J1165 00641049325 12/31/2999 12/31/2999J1165 00641255541 12/31/2999 12/31/2999J1165 00641255545 12/31/2999 12/31/2999J1165 00641613825 12/31/2999 12/31/2999J1165 00641613925 12/31/2999 12/31/2999J1165 39822405003 12/31/2999 12/31/2999J1165 39822405006 12/31/2999 12/31/2999J1170 00409128305 12/31/2999 12/31/2999J1170 00409128310 12/31/2999 12/31/2999J1170 00409128331 12/31/2999 12/31/2999

Page 53: *This document is a compilation of NDC:HCPCS combinations

J1170 00409130431 12/31/2999 12/31/2999J1170 00409131210 12/31/2999 12/31/2999J1170 00409131230 12/31/2999 12/31/2999J1170 00409254001 12/31/2999 12/31/2999J1170 00409255201 12/31/2999 12/31/2999J1170 00409263401 12/31/2999 12/31/2999J1170 00409263405 12/31/2999 12/31/2999J1170 00409263450 12/31/2999 12/31/2999J1170 00409335601 12/31/2999 12/31/2999J1170 00409336501 12/31/2999 12/31/2999J1170 00641012121 12/31/2999 12/31/2999J1170 00641012125 12/31/2999 12/31/2999J1170 00641234139 12/31/2999 12/31/2999J1170 00641234141 12/31/2999 12/31/2999J1170 00703001801 12/31/2999 12/31/2999J1170 00703011003 12/31/2999 12/31/2999J1170 00703011303 12/31/2999 12/31/2999J1170 17478054001 12/31/2999 12/31/2999J1170 17478054005 12/31/2999 12/31/2999J1170 17478054050 12/31/2999 12/31/2999J1170 45183070268 12/31/2999 12/31/2999J1170 54868513700 12/31/2999 6/30/2011J1170 54868531900 12/31/2999 6/30/2011J1170 59011044110 12/31/2999 12/31/2999J1170 59011044210 12/31/2999 12/31/2999J1170 59011044225 12/31/2999 12/31/2999J1170 59011044410 12/31/2999 12/31/2999J1170 59011044501 12/31/2999 12/31/2999J1170 59011044505 12/31/2999 12/31/2999J1170 59011044550 12/31/2999 12/31/2999J1170 59011044625 12/31/2999 12/31/2999J1170 61553016141 12/31/2999 12/31/2999J1170 61553016267 12/31/2999 12/31/2999J1170 61553016375 12/31/2999 12/31/2999J1170 61553016541 12/31/2999 12/31/2999J1170 61553016667 12/31/2999 12/31/2999J1170 61553016775 12/31/2999 12/31/2999J1170 61553020648 12/31/2999 12/31/2999J1170 61553020701 12/31/2999 12/31/2999J1170 61553020837 12/31/2999 12/31/2999J1170 61553020902 12/31/2999 12/31/2999J1170 61553050469 12/31/2999 12/31/2999J1170 61553062448 12/31/2999 12/31/2999J1170 61553068176 12/31/2999 12/31/2999J1170 61553068267 12/31/2999 12/31/2999J1170 61553070168 12/31/2999 12/31/2999J1170 61553070268 12/31/2999 12/31/2999

Page 54: *This document is a compilation of NDC:HCPCS combinations

J1170 61553070468 12/31/2999 12/31/2999J1170 61553070568 12/31/2999 12/31/2999J1170 61553070668 12/31/2999 12/31/2999J1170 61553071068 12/31/2999 12/31/2999J1170 61553071268 12/31/2999 12/31/2999J1170 61553078068 12/31/2999 12/31/2999J1190 00013871562 12/31/2999 1/1/2009J1190 00013871762 12/31/2999 12/31/2999J1190 00013872589 12/31/2999 1/1/2009J1190 00013872789 12/31/2999 12/31/2999J1190 38423011001 12/31/2999 12/31/2999J1190 55390001402 12/31/2999 12/31/2999J1190 55390006002 12/31/2999 12/31/2999J1190 67457020725 12/31/2999 12/31/2999J1190 67457020850 12/31/2999 12/31/2999J1200 00409229031 12/31/2999 12/31/2999J1200 00548139000 12/31/2999 6/1/2008J1200 00641037621 12/31/2999 12/31/2999J1200 00641037625 12/31/2999 12/31/2999J1200 49999052510 12/31/2999 4/4/2011J1200 54569560800 12/31/2999 12/31/2999J1200 54569581500 12/31/2999 12/31/2999J1200 54868000700 12/31/2999 4/30/2008J1200 54868204800 12/31/2999 8/30/2011J1200 54868204801 12/31/2999 8/30/2011J1200 63323066401 12/31/2999 12/31/2999J1200 67457012410 12/31/2999 12/31/2999J1200 76045010210 12/31/2999 12/31/2999J1205 17478041940 12/31/2999 12/31/2999J1205 47335033040 12/31/2999 12/31/2999J1205 63323065820 12/31/2999 12/31/2999J1205 63323065827 12/31/2999 12/31/2999J1205 63323065894 12/31/2999 12/31/2999J1205 76478071140 12/31/2999 12/31/2999J1212 67457017750 12/31/2999 12/31/2999J1230 66479053002 12/31/2999 5/17/2010J1230 67457021720 12/31/2999 12/31/2999J1240 63323036601 12/31/2999 12/31/2999J1245 00641256944 12/31/2999 12/31/2999J1245 55390055510 12/31/2999 5/2/2011J1245 55390055590 12/31/2999 5/2/2011J1250 00074234534 12/31/2999 7/19/2011J1250 00338107302 12/31/2999 12/31/2999J1250 00338107502 12/31/2999 12/31/2999J1250 00338107702 12/31/2999 12/31/2999J1250 00409202520 12/31/2999 12/31/2999J1250 00409202554 12/31/2999 12/31/2999

Page 55: *This document is a compilation of NDC:HCPCS combinations

J1250 00409234401 12/31/2999 12/31/2999J1250 00409234402 12/31/2999 12/31/2999J1250 00409234488 12/31/2999 12/31/2999J1250 00409234632 12/31/2999 12/31/2999J1250 00409234634 12/31/2999 12/31/2999J1250 00409234732 12/31/2999 12/31/2999J1250 00409234733 12/31/2999 12/31/2999J1250 00409372432 12/31/2999 12/31/2999J1250 54868571700 12/31/2999 6/30/2011J1250 54868571701 12/31/2999 6/30/2011J1250 54868571702 12/31/2999 6/30/2011J1250 54868577700 12/31/2999 6/30/2012J1250 55390056090 12/31/2999 12/31/2999J1260 00088120632 12/31/2999 12/31/2999J1260 00088120806 12/31/2999 12/31/2999J1260 00088120926 12/31/2999 12/31/2999J1265 00264148155 12/31/2999 1/31/2011J1265 00338100502 12/31/2999 12/31/2999J1265 00338100503 12/31/2999 12/31/2999J1265 00338100702 12/31/2999 12/31/2999J1265 00338100703 12/31/2999 12/31/2999J1265 00338100902 12/31/2999 12/31/2999J1265 00409426501 12/31/2999 12/31/2999J1265 00409582001 12/31/2999 12/31/2999J1265 00409780822 12/31/2999 12/31/2999J1265 00409780824 12/31/2999 12/31/2999J1265 00409780922 12/31/2999 12/31/2999J1265 00409780924 12/31/2999 12/31/2999J1265 00409781022 12/31/2999 12/31/2999J1265 00409910420 12/31/2999 12/31/2999J1265 00517130525 12/31/2999 12/31/2999J1265 00517180525 12/31/2999 12/31/2999J1265 00517190525 12/31/2999 12/31/2999J1265 54868001500 12/31/2999 6/30/2012J1265 54868358300 12/31/2999 9/30/2001J1267 50458040101 12/31/2999 12/31/2999J1267 50458040102 12/31/2999 12/31/2999J1267 50458040202 12/31/2999 12/31/2999J1267 59630030910 12/31/2999 12/31/2999J1267 59630032010 12/31/2999 12/31/2999J1270 58468012301 12/31/2999 12/31/2999J1270 58468012601 12/31/2999 12/31/2999J1290 47783010101 12/31/2999 12/31/2999J1300 25682000101 12/31/2999 12/31/2999J1324 00004038039 6/30/2013 7/2/2013J1324 00004038140 12/31/2999 12/31/2999J1324 35356020660 12/31/2999 1/1/2012

Page 56: *This document is a compilation of NDC:HCPCS combinations

J1324 54569578100 12/31/2999 12/31/2999J1325 00173051700 12/31/2999 12/31/2999J1325 00173051900 12/31/2999 12/31/2999J1325 00703198501 12/31/2999 12/31/2999J1325 00703199501 12/31/2999 12/31/2999J1325 66215040101 12/31/2999 12/31/2999J1325 66215040201 12/31/2999 12/31/2999J1325 66215040301 12/31/2999 12/31/2999J1327 00085113601 12/31/2999 12/31/2999J1327 00085117701 12/31/2999 12/31/2999J1327 00085117702 12/31/2999 12/31/2999J1335 00006384371 12/31/2999 12/31/2999J1335 00006384571 12/31/2999 12/31/2999J1364 00409647644 12/31/2999 12/31/2999J1364 00409648201 12/31/2999 12/31/2999J1380 00574087005 12/31/2999 12/31/2999J1380 00574087205 12/31/2999 12/31/2999J1380 00781302975 12/31/2999 10/1/2010J1380 00781303075 12/31/2999 9/30/2008J1380 42023011001 12/31/2999 12/31/2999J1380 42023011101 12/31/2999 12/31/2999J1380 42023011201 12/31/2999 12/31/2999J1380 42023013401 12/31/2999 12/31/2999J1380 42023013501 12/31/2999 12/31/2999J1380 42023013601 12/31/2999 12/31/2999J1410 00046074905 12/31/2999 12/31/2999J1430 67871479006 12/31/2999 12/31/2999J1438 54868478200 12/31/2999 6/30/2012J1438 54868544400 12/31/2999 12/31/2999J1438 58406042534 12/31/2999 12/31/2999J1438 58406042541 12/31/2999 12/31/2999J1438 58406043501 12/31/2999 12/31/2999J1438 58406043504 12/31/2999 12/31/2999J1438 58406044501 12/31/2999 12/31/2999J1438 58406044504 12/31/2999 12/31/2999J1438 58406045501 12/31/2999 12/31/2999J1438 58406045504 12/31/2999 12/31/2999J1440 54868252200 12/31/2999 6/30/2010J1440 54868502000 12/31/2999 6/30/2012J1440 55513053001 12/31/2999 12/31/2999J1440 55513053010 12/31/2999 12/31/2999J1440 55513092401 12/31/2999 12/31/2999J1440 55513092410 12/31/2999 12/31/2999J1441 54868252200 12/31/2999 6/30/2010J1441 54868305000 12/31/2999 6/30/2010J1441 54868502000 12/31/2999 6/30/2012J1441 55513020901 12/31/2999 12/31/2999

Page 57: *This document is a compilation of NDC:HCPCS combinations

J1441 55513020910 12/31/2999 12/31/2999J1441 55513054601 12/31/2999 12/31/2999J1441 55513054610 12/31/2999 12/31/2999J1442 55513020910 12/31/2999 12/31/2999J1442 55513053010 12/31/2999 12/31/2999J1442 55513054610 12/31/2999 12/31/2999J1442 55513092410 12/31/2999 12/31/2999J1446 63459091011 12/31/2999 12/31/2999J1446 63459091015 12/31/2999 12/31/2999J1446 63459091211 12/31/2999 12/31/2999J1446 63459091215 12/31/2999 12/31/2999J1450 00049337226 11/1/2014 10/22/2010J1450 00069003803 12/31/2999 12/31/2999J1450 00069004503 12/31/2999 12/31/2999J1450 00143966606 12/31/2999 12/31/2999J1450 00143966706 12/31/2999 12/31/2999J1450 00143966806 12/31/2999 12/31/2999J1450 00143966906 12/31/2999 12/31/2999J1450 00143989991 12/31/2999 12/31/2999J1450 00338604537 12/31/2999 12/31/2999J1450 00338604648 12/31/2999 12/31/2999J1450 00409468402 12/31/2999 12/31/2999J1450 00409468423 12/31/2999 12/31/2999J1450 00409468802 12/31/2999 12/31/2999J1450 00409468823 12/31/2999 12/31/2999J1450 00409468827 12/31/2999 12/31/2999J1450 00409468828 12/31/2999 12/31/2999J1450 00409468833 12/31/2999 12/31/2999J1450 00409468834 12/31/2999 12/31/2999J1450 00703101009 12/31/2999 12/31/2999J1450 00703101909 12/31/2999 12/31/2999J1450 00703102030 12/31/2999 12/31/2999J1450 00703102930 12/31/2999 12/31/2999J1450 25021011382 12/31/2999 12/31/2999J1450 25021011387 12/31/2999 12/31/2999J1450 55390001201 12/31/2999 12/31/2999J1450 55390004601 12/31/2999 12/31/2999J1450 55390019401 12/31/2999 12/31/2999J1450 55390022701 12/31/2999 12/31/2999J1450 55390022801 12/31/2999 12/31/2999J1450 61703041463 12/31/2999 7/1/2009J1450 61703041464 12/31/2999 7/1/2009J1450 63323030861 12/31/2999 5/10/2007J1450 63323030863 12/31/2999 5/10/2007J1451 00781318273 12/31/2999 12/31/2999J1451 00781318284 12/31/2999 12/31/2999J1451 10139091015 12/31/2999 9/23/2011

Page 58: *This document is a compilation of NDC:HCPCS combinations

J1451 39822071001 12/31/2999 12/31/2999J1451 67457021102 12/31/2999 12/31/2999J1453 00006394132 12/31/2999 12/31/2999J1455 00409386302 12/31/2999 12/31/2999J1455 00409386305 12/31/2999 12/31/2999J1457 66657030101 12/31/2999 12/31/2999J1457 66657030105 12/31/2999 12/31/2999J1458 68135002001 12/31/2999 12/31/2999J1459 44206043605 12/31/2999 12/31/2999J1459 44206043710 12/31/2999 12/31/2999J1459 44206043820 12/31/2999 12/31/2999J1459 44206043940 12/31/2999 12/31/2999J1460 13533063503 12/31/2999 6/1/2011J1460 13533063504 12/31/2999 12/31/2999J1460 13533063512 12/31/2999 12/31/2999J1460 14362011502 12/31/2999 6/15/2007J1460 54569582800 12/31/2999 12/31/2999J1556 59730650201 12/31/2999 12/31/2999J1556 59730650301 12/31/2999 12/31/2999J1557 64208823401 12/31/2999 12/31/2999J1557 64208823402 12/31/2999 12/31/2999J1557 64208823403 12/31/2999 12/31/2999J1559 44206045101 12/31/2999 12/31/2999J1559 44206045202 12/31/2999 12/31/2999J1559 44206045404 12/31/2999 12/31/2999J1559 44206045510 12/31/2999 12/31/2999J1560 13533063503 12/31/2999 6/1/2011J1560 13533063504 12/31/2999 12/31/2999J1560 13533063512 12/31/2999 12/31/2999J1560 14362011502 12/31/2999 6/15/2007J1561 13533064512 3/24/2013 12/31/2999J1561 13533064515 4/19/2013 4/19/2013J1561 13533064520 6/26/2014 12/31/2999J1561 13533064524 10/17/2013 12/31/2999J1561 13533064571 10/22/2013 12/31/2999J1561 13533080012 12/31/2999 12/31/2999J1561 13533080015 12/31/2999 12/31/2999J1561 13533080020 12/31/2999 12/31/2999J1561 13533080024 12/31/2999 12/31/2999J1561 13533080071 12/31/2999 12/31/2999J1561 76125090001 12/31/2999 12/31/2999J1561 76125090010 12/31/2999 12/31/2999J1561 76125090020 12/31/2999 12/31/2999J1561 76125090025 12/31/2999 12/31/2999J1561 76125090050 12/31/2999 12/31/2999J1562 00053759601 9/7/2013 2/24/2011J1562 00053759603 12/31/2999 2/10/2010

Page 59: *This document is a compilation of NDC:HCPCS combinations

J1562 00053759610 5/6/2013 2/24/2011J1562 00053759620 6/8/2013 2/24/2011J1566 00944262001 12/31/2999 12/3/2010J1566 00944262002 12/31/2999 12/31/2999J1566 00944262003 12/31/2999 12/31/2999J1566 00944262004 12/31/2999 12/31/2999J1566 00944265503 12/31/2999 12/31/2999J1566 00944265504 12/31/2999 12/31/2999J1566 00944265603 12/31/2999 12/31/2999J1566 00944265804 12/31/2999 12/31/2999J1566 44206041603 6/3/2014 12/31/2999J1566 44206041706 12/31/2999 12/31/2999J1566 44206041812 12/31/2999 12/31/2999J1568 67467084301 12/31/2999 12/31/2999J1568 67467084302 12/31/2999 12/31/2999J1568 67467084303 12/31/2999 12/31/2999J1568 67467084304 12/31/2999 12/31/2999J1568 67467084305 12/31/2999 12/31/2999J1568 68209084301 12/31/2999 12/31/2999J1568 68209084302 12/31/2999 12/31/2999J1568 68209084303 12/31/2999 12/31/2999J1568 68209084304 12/31/2999 12/31/2999J1569 00944262003 12/31/2999 12/31/2999J1569 00944262004 12/31/2999 12/31/2999J1569 00944270002 12/31/2999 12/31/2999J1569 00944270003 12/31/2999 12/31/2999J1569 00944270004 12/31/2999 12/31/2999J1569 00944270005 12/31/2999 12/31/2999J1569 00944270006 12/31/2999 12/31/2999J1569 00944270007 12/31/2999 12/31/2999J1570 00004694003 12/31/2999 12/31/2999J1570 63323031510 12/31/2999 12/31/2999J1571 53270005101 12/31/2999 12/31/2999J1571 53270005201 12/31/2999 12/31/2999J1571 53270005301 12/31/2999 12/31/2999J1571 53270005401 12/31/2999 12/31/2999J1571 60492005101 12/31/2999 4/17/2013J1571 60492005102 12/31/2999 7/31/2010J1571 60492005201 12/31/2999 4/17/2013J1571 60492005202 12/31/2999 7/31/2010J1572 61953000301 12/31/2999 7/27/2007J1572 61953000302 12/31/2999 3/17/2009J1572 61953000303 12/31/2999 5/26/2010J1572 61953000304 12/31/2999 7/8/2010J1572 61953000401 12/31/2999 12/31/2999J1572 61953000402 12/31/2999 12/31/2999J1572 61953000403 12/31/2999 12/31/2999

Page 60: *This document is a compilation of NDC:HCPCS combinations

J1572 61953000404 12/31/2999 12/31/2999J1572 61953000405 12/31/2999 12/31/2999J1572 61953000501 12/31/2999 12/31/2999J1572 61953000502 12/31/2999 12/31/2999J1572 61953000503 12/31/2999 12/31/2999J1573 53270005101 12/31/2999 12/31/2999J1573 53270005201 12/31/2999 12/31/2999J1573 53270005301 12/31/2999 12/31/2999J1573 53270005401 12/31/2999 12/31/2999J1573 60492005101 12/31/2999 4/17/2013J1573 60492005102 12/31/2999 7/31/2010J1573 60492005201 12/31/2999 4/17/2013J1573 60492005202 12/31/2999 7/31/2010J1580 00264580632 12/31/2999 11/30/2010J1580 00264580832 3/31/2013 3/31/2013J1580 00264581032 4/30/2013 4/30/2013J1580 00264581638 4/30/2013 4/30/2013J1580 00338050348 12/31/2999 12/31/2999J1580 00338050548 12/31/2999 12/31/2999J1580 00338050741 12/31/2999 12/31/2999J1580 00338050748 12/31/2999 12/31/2999J1580 00338050941 12/31/2999 12/31/2999J1580 00338051141 12/31/2999 12/31/2999J1580 00409120703 12/31/2999 12/31/2999J1580 00409340001 12/31/2999 12/31/2999J1580 00409340101 12/31/2999 12/31/2999J1580 00409340201 12/31/2999 12/31/2999J1580 00409787913 12/31/2999 12/31/2999J1580 00409788113 12/31/2999 12/31/2999J1580 00409788313 12/31/2999 12/31/2999J1580 00409788423 12/31/2999 12/31/2999J1580 00409788623 12/31/2999 12/31/2999J1580 00409788923 12/31/2999 12/31/2999J1580 54868410300 12/31/2999 6/30/2002J1580 63323001002 12/31/2999 12/31/2999J1580 63323001020 12/31/2999 12/31/2999J1580 63323001094 12/31/2999 12/31/2999J1580 63323001095 12/31/2999 12/31/2999J1580 63323017302 12/31/2999 12/31/2999J1580 63323017394 12/31/2999 12/31/2999J1580 63323051302 12/31/2999 12/31/2999J1595 68546031730 12/31/2999 12/31/2999J1600 11098053310 12/31/2999 11/8/2010J1600 17478053301 12/31/2999 11/1/2011J1600 54643100600 12/31/2999 3/1/2009J1600 54643100700 12/31/2999 3/1/2009J1602 57894035001 12/31/2999 12/31/2999

Page 61: *This document is a compilation of NDC:HCPCS combinations

J1610 00002803101 12/31/2999 12/31/2999J1610 00169706515 12/31/2999 12/31/2999J1610 00169706521 12/31/2999 12/31/2999J1610 54569473400 12/31/2999 12/31/2999J1610 54868507000 12/31/2999 6/30/2012J1610 55390000401 12/31/2999 12/31/2999J1610 55390000410 12/31/2999 12/31/2999J1626 00143974410 12/31/2999 12/31/2999J1626 00143974505 12/31/2999 12/31/2999J1626 00703789101 12/31/2999 12/31/2999J1626 00703797103 12/31/2999 12/31/2999J1626 00703797301 12/31/2999 12/31/2999J1626 17478054601 3/31/2013 7/25/2012J1626 17478054602 12/31/2999 12/31/2999J1626 17478054605 12/31/2999 12/31/2999J1626 25021077801 12/31/2999 12/31/2999J1626 25021077866 12/31/2999 12/31/2999J1626 25021077901 12/31/2999 12/31/2999J1626 25021078104 12/31/2999 12/31/2999J1626 55390025010 12/31/2999 5/2/2011J1626 63323031701 12/31/2999 12/31/2999J1626 63323031801 12/31/2999 12/31/2999J1626 63323031904 12/31/2999 12/31/2999J1626 64679066102 12/31/2999 12/31/2999J1626 64679066103 12/31/2999 12/31/2999J1626 66758003501 12/31/2999 12/31/2999J1626 66758003601 12/31/2999 12/31/2999J1626 66758003702 12/31/2999 11/16/2009J1626 66860008106 12/31/2999 12/31/2999J1626 66860008206 12/31/2999 12/31/2999J1626 66860008301 12/31/2999 12/31/2999J1630 00069011302 12/31/2999 12/31/2999J1630 00703704104 12/31/2999 12/31/2999J1630 00703704501 12/31/2999 12/31/2999J1630 10147091101 12/31/2999 12/31/2999J1630 25021080601 12/31/2999 12/31/2999J1630 25021082310 12/31/2999 12/31/2999J1630 50458025501 12/31/2999 12/31/2999J1630 54868345900 12/31/2999 6/30/2012J1630 55390014701 12/31/2999 12/31/2999J1630 55390014710 12/31/2999 12/31/2999J1630 55390044701 12/31/2999 5/2/2011J1630 63323047401 12/31/2999 12/31/2999J1630 63323047410 12/31/2999 12/31/2999J1630 63323047491 12/31/2999 5/10/2007J1631 00703701103 12/31/2999 12/31/2999J1631 00703701301 12/31/2999 12/31/2999

Page 62: *This document is a compilation of NDC:HCPCS combinations

J1631 00703702103 12/31/2999 12/31/2999J1631 00703702301 12/31/2999 12/31/2999J1631 10147092103 12/31/2999 12/31/2999J1631 10147092205 12/31/2999 12/31/2999J1631 50458025303 12/31/2999 12/31/2999J1631 50458025414 12/31/2999 12/31/2999J1631 53150041510 12/31/2999 12/31/2999J1631 53150042205 12/31/2999 12/31/2999J1631 53150048505 12/31/2999 12/31/2999J1631 53150048905 12/31/2999 12/31/2999J1631 54868288900 12/31/2999 6/30/2012J1631 54868288901 12/31/2999 6/30/2012J1631 55390041201 12/31/2999 5/2/2011J1631 55390041205 12/31/2999 5/2/2011J1631 55390041301 12/31/2999 5/2/2011J1631 55390041305 12/31/2999 5/2/2011J1631 60505070201 12/31/2999 12/31/2999J1631 60505070301 12/31/2999 12/31/2999J1631 60505602002 12/31/2999 12/31/2999J1631 60505602102 12/31/2999 12/31/2999J1631 63323046901 12/31/2999 12/31/2999J1631 63323046905 12/31/2999 12/31/2999J1631 63323047101 12/31/2999 12/31/2999J1631 63323047105 12/31/2999 12/31/2999J1640 67386070154 12/31/2999 12/31/2999J1642 00409115112 12/31/2999 3/1/2011J1642 00409115170 12/31/2999 12/31/2999J1642 00409115178 12/31/2999 2/1/2011J1642 00409115270 12/31/2999 12/31/2999J1642 00409115278 12/31/2999 12/31/2999J1642 00409128031 12/31/2999 12/31/2999J1642 00409128032 12/31/2999 12/31/2999J1642 00409128033 12/31/2999 12/31/2999J1642 00409128035 12/31/2999 12/31/2999J1642 00409128131 12/31/2999 12/31/2999J1642 00409128132 12/31/2999 12/31/2999J1642 00409128133 12/31/2999 12/31/2999J1642 00409128135 12/31/2999 12/31/2999J1642 08166110005 12/31/2999 1/2/2001J1642 08166111005 12/31/2999 1/2/2001J1642 08290034002 12/31/2999 12/31/2999J1642 08290034003 12/31/2999 12/31/2999J1642 08290035005 12/31/2999 12/31/2999J1642 08290036003 12/31/2999 12/31/2999J1642 08290036005 12/31/2999 12/31/2999J1642 08290036006 12/31/2999 12/31/2999J1642 08290036105 12/31/2999 12/31/2999

Page 63: *This document is a compilation of NDC:HCPCS combinations

J1642 08290037002 12/31/2999 12/31/2999J1642 08290037003 12/31/2999 12/31/2999J1642 08290038003 12/31/2999 12/31/2999J1642 08290038005 12/31/2999 12/31/2999J1642 08290039003 12/31/2999 12/31/2999J1642 08290039005 12/31/2999 12/31/2999J1642 08290039105 12/31/2999 12/31/2999J1642 08290040003 12/31/2999 12/31/2999J1642 08290042005 12/31/2999 12/31/2999J1642 08290306413 12/31/2999 12/31/2999J1642 08290306414 12/31/2999 12/31/2999J1642 08290306423 12/31/2999 12/31/2999J1642 08290306424 12/31/2999 12/31/2999J1642 08450602603 12/31/2999 6/1/2004J1642 08450603005 12/31/2999 6/1/2004J1642 08450603403 12/31/2999 6/1/2004J1642 08450603705 12/31/2999 6/1/2004J1642 08450604603 12/31/2999 6/1/2004J1642 08450604903 12/31/2999 6/1/2004J1642 08450605005 12/31/2999 6/1/2004J1642 08450605503 12/31/2999 6/1/2004J1642 08450605805 12/31/2999 6/1/2004J1642 08881580121 12/31/2999 12/31/2999J1642 08881580123 12/31/2999 12/31/2999J1642 08881580125 12/31/2999 12/31/2999J1642 08881581125 12/31/2999 12/31/2999J1642 08881590121 12/31/2999 12/31/2999J1642 08881590123 12/31/2999 12/31/2999J1642 08881590125 12/31/2999 12/31/2999J1642 17474012301 12/31/2999 3/1/2009J1642 17474012302 12/31/2999 8/1/2008J1642 17474012303 12/31/2999 3/1/2009J1642 17474012305 12/31/2999 3/1/2009J1642 17474012501 12/31/2999 3/1/2009J1642 17474012502 12/31/2999 8/1/2008J1642 17474012503 12/31/2999 3/1/2009J1642 17474012505 12/31/2999 3/1/2009J1642 54868252600 12/31/2999 12/1/2003J1642 54868361500 12/31/2999 12/1/2003J1642 63323001710 12/31/2999 12/31/2999J1642 63323054401 12/31/2999 12/31/2999J1642 63323054411 12/31/2999 12/31/2999J1642 63323054501 12/31/2999 12/31/2999J1642 63807030035 12/31/2999 1/1/2011J1642 63807036031 12/31/2999 2/1/2013J1642 63807040035 12/31/2999 1/1/2011J1642 63807050005 12/31/2999 12/31/2999

Page 64: *This document is a compilation of NDC:HCPCS combinations

J1642 63807050050 12/31/2999 2/1/2013J1642 63807050051 12/31/2999 12/31/2999J1642 63807050055 12/31/2999 12/31/2999J1642 63807050512 12/31/2999 12/31/2999J1642 63807056031 12/31/2999 2/1/2013J1642 63807056051 12/31/2999 2/1/2013J1642 63807060005 12/31/2999 12/31/2999J1642 63807060031 12/31/2999 12/31/2999J1642 63807060050 12/31/2999 2/1/2013J1642 63807060051 12/31/2999 12/31/2999J1642 63807060055 12/31/2999 12/31/2999J1642 63807060512 12/31/2999 12/31/2999J1642 63807066031 12/31/2999 2/1/2013J1642 63807066051 12/31/2999 2/1/2013J1642 64054100003 12/31/2999 11/1/2003J1642 64054100103 12/31/2999 11/1/2003J1642 64054100202 12/31/2999 11/1/2003J1642 64054100203 12/31/2999 11/1/2003J1642 64054100206 12/31/2999 11/1/2003J1642 64054100306 12/31/2999 11/1/2003J1642 64054100402 12/31/2999 11/1/2003J1642 64054100902 12/31/2999 11/1/2003J1642 64054300003 12/31/2999 11/1/2003J1642 64054300202 12/31/2999 11/1/2003J1642 64054300206 12/31/2999 11/1/2003J1642 64054300301 12/31/2999 11/1/2003J1642 64054300402 12/31/2999 11/1/2003J1642 64054300406 12/31/2999 11/1/2003J1642 64054300902 12/31/2999 11/1/2003J1642 64253022221 12/31/2999 12/31/2999J1642 64253022222 12/31/2999 12/31/2999J1642 64253022223 12/31/2999 12/31/2999J1642 64253022225 12/31/2999 12/31/2999J1642 64253022230 12/31/2999 12/31/2999J1642 64253022233 12/31/2999 12/31/2999J1642 64253022235 12/31/2999 12/31/2999J1642 64253033321 12/31/2999 12/31/2999J1642 64253033322 12/31/2999 12/31/2999J1642 64253033323 12/31/2999 12/31/2999J1642 64253033325 12/31/2999 12/31/2999J1642 64253033330 12/31/2999 12/31/2999J1642 64253033333 12/31/2999 12/31/2999J1642 64253033335 12/31/2999 12/31/2999J1642 64253044421 12/31/2999 12/31/2999J1642 64253044422 12/31/2999 12/31/2999J1642 64253044423 12/31/2999 12/31/2999J1642 64253044425 12/31/2999 12/31/2999

Page 65: *This document is a compilation of NDC:HCPCS combinations

J1642 64253044430 12/31/2999 12/31/2999J1642 64253044433 12/31/2999 12/31/2999J1642 64253044435 12/31/2999 12/31/2999J1642 68883001003 12/31/2999 8/1/2011J1642 68883001005 12/31/2999 8/1/2011J1642 68883001006 12/31/2999 8/1/2011J1642 68883010003 12/31/2999 8/1/2011J1642 68883010004 12/31/2999 8/1/2011J1642 68883010005 12/31/2999 8/1/2011J1642 68883010006 12/31/2999 8/1/2011J1644 00069004301 12/31/2999 12/31/2999J1644 00069005801 12/31/2999 12/31/2999J1644 00069005901 12/31/2999 12/31/2999J1644 00069005903 12/31/2999 12/31/2999J1644 00069006201 12/31/2999 12/31/2999J1644 00069013703 12/31/2999 12/31/2999J1644 00264956710 12/31/2999 12/31/2999J1644 00264957710 12/31/2999 12/31/2999J1644 00264958720 12/31/2999 12/31/2999J1644 00264987210 12/31/2999 12/31/2999J1644 00338043103 12/31/2999 12/31/2999J1644 00338043304 12/31/2999 12/31/2999J1644 00338054903 12/31/2999 1/31/2011J1644 00338055002 12/31/2999 1/31/2011J1644 00338055003 12/31/2999 1/31/2011J1644 00409131632 12/31/2999 12/31/2999J1644 00409131666 12/31/2999 10/1/2010J1644 00409140212 12/31/2999 12/31/2999J1644 00409258402 12/31/2999 12/1/2010J1644 00409272001 12/31/2999 12/31/2999J1644 00409272002 12/31/2999 12/31/2999J1644 00409272003 12/31/2999 12/31/2999J1644 00409272101 12/31/2999 12/31/2999J1644 00409272301 12/31/2999 12/31/2999J1644 00409272302 12/31/2999 12/31/2999J1644 00409762003 12/31/2999 12/31/2999J1644 00409762059 12/31/2999 12/31/2999J1644 00409765062 12/31/2999 12/31/2999J1644 00409765103 12/31/2999 12/31/2999J1644 00409765162 12/31/2999 12/31/2999J1644 00409776003 12/31/2999 12/31/2999J1644 00409776103 12/31/2999 12/31/2999J1644 00409779362 12/31/2999 12/31/2999J1644 00409779462 12/31/2999 12/31/2999J1644 00641039112 12/31/2999 12/31/2999J1644 00641040012 12/31/2999 12/31/2999J1644 00641041012 12/31/2999 12/31/2999

Page 66: *This document is a compilation of NDC:HCPCS combinations

J1644 00641245055 12/31/2999 12/31/2999J1644 00641246055 12/31/2999 12/31/2999J1644 25021040001 12/31/2999 12/31/2999J1644 25021040010 12/31/2999 12/31/2999J1644 25021040030 12/31/2999 12/31/2999J1644 25021040102 12/31/2999 12/31/2999J1644 25021040201 12/31/2999 12/31/2999J1644 25021040210 12/31/2999 12/31/2999J1644 25021040301 12/31/2999 12/31/2999J1644 25021040304 12/31/2999 12/31/2999J1644 25021040401 12/31/2999 12/31/2999J1644 61553040046 12/31/2999 12/31/2999J1644 61553040102 12/31/2999 4/12/2013J1644 61553040246 12/31/2999 12/31/2999J1644 61553040302 12/31/2999 4/12/2013J1644 63323004710 12/31/2999 12/31/2999J1644 63323026201 12/31/2999 12/31/2999J1644 63323026255 12/31/2999 12/31/2999J1644 63323027602 12/31/2999 12/31/2999J1644 63323045909 12/31/2999 12/31/2999J1644 63323054001 12/31/2999 12/31/2999J1644 63323054011 12/31/2999 12/31/2999J1644 63323054031 12/31/2999 12/31/2999J1644 63323054057 12/31/2999 12/31/2999J1644 63323054201 12/31/2999 12/31/2999J1644 63323054207 12/31/2999 12/31/2999J1644 63323054302 12/31/2999 12/31/2999J1644 63323091501 12/31/2999 12/31/2999J1645 62856010101 12/31/2999 12/31/2999J1645 62856010110 12/31/2999 12/31/2999J1645 62856012501 12/31/2999 12/31/2999J1645 62856012510 12/31/2999 12/31/2999J1645 62856015001 12/31/2999 12/31/2999J1645 62856015010 12/31/2999 12/31/2999J1645 62856018001 12/31/2999 12/31/2999J1645 62856018010 12/31/2999 12/31/2999J1645 62856025001 12/31/2999 12/31/2999J1645 62856025010 12/31/2999 12/31/2999J1645 62856025101 12/31/2999 12/31/2999J1645 62856050001 12/31/2999 12/31/2999J1645 62856050010 12/31/2999 12/31/2999J1645 62856075001 12/31/2999 12/31/2999J1645 62856075010 12/31/2999 12/31/2999J1650 00075062040 12/31/2999 12/31/2999J1650 00075062041 12/31/2999 12/31/2999J1650 00075062160 12/31/2999 12/31/2999J1650 00075062161 12/31/2999 12/31/2999

Page 67: *This document is a compilation of NDC:HCPCS combinations

J1650 00075062280 12/31/2999 12/31/2999J1650 00075062281 12/31/2999 12/31/2999J1650 00075062300 12/31/2999 12/31/2999J1650 00075062301 12/31/2999 12/31/2999J1650 00075062430 12/31/2999 12/31/2999J1650 00075062431 12/31/2999 12/31/2999J1650 00075062603 12/31/2999 12/31/2999J1650 00075062604 12/31/2999 12/31/2999J1650 00075291201 12/31/2999 12/31/2999J1650 00075291202 12/31/2999 12/31/2999J1650 00075291501 12/31/2999 12/31/2999J1650 00075291502 12/31/2999 12/31/2999J1650 00075801310 12/31/2999 12/31/2999J1650 00075801410 12/31/2999 12/31/2999J1650 00075801610 12/31/2999 12/31/2999J1650 00075801810 12/31/2999 12/31/2999J1650 00075802010 12/31/2999 12/31/2999J1650 00075802210 12/31/2999 12/31/2999J1650 00075803001 12/31/2999 12/31/2999J1650 00548560100 12/31/2999 12/31/2999J1650 00548560200 12/31/2999 12/31/2999J1650 00548560300 12/31/2999 12/31/2999J1650 00548560400 12/31/2999 12/31/2999J1650 00548560500 12/31/2999 12/31/2999J1650 00548560600 12/31/2999 12/31/2999J1650 00548560700 12/31/2999 12/31/2999J1650 00548563100 12/31/2999 12/31/2999J1650 00548563200 12/31/2999 12/31/2999J1650 00548563300 12/31/2999 12/31/2999J1650 00548563400 12/31/2999 12/31/2999J1650 00548563500 12/31/2999 12/31/2999J1650 00548563600 12/31/2999 12/31/2999J1650 00548563700 12/31/2999 12/31/2999J1650 00781311963 7/31/2013 1/4/2012J1650 00781311964 6/30/2013 1/4/2012J1650 00781311966 7/31/2013 11/1/2011J1650 00781311968 7/31/2013 1/4/2012J1650 00781311969 6/30/2013 1/4/2012J1650 00781312168 7/31/2013 1/4/2012J1650 00781312169 6/30/2013 1/4/2012J1650 00781312293 12/31/2999 12/31/2999J1650 00781313363 12/31/2999 12/31/2999J1650 00781322464 12/31/2999 12/31/2999J1650 00781335666 12/31/2999 12/31/2999J1650 00781342868 12/31/2999 12/31/2999J1650 00781350069 12/31/2999 12/31/2999J1650 00781361268 12/31/2999 12/31/2999

Page 68: *This document is a compilation of NDC:HCPCS combinations

J1650 00781365569 12/31/2999 12/31/2999J1650 00955100310 12/31/2999 12/31/2999J1650 00955100410 12/31/2999 12/31/2999J1650 00955100610 12/31/2999 12/31/2999J1650 00955100810 12/31/2999 12/31/2999J1650 00955101010 12/31/2999 12/31/2999J1650 00955101210 12/31/2999 12/31/2999J1650 00955101510 12/31/2999 12/31/2999J1650 00955101601 12/31/2999 12/31/2999J1650 35356048110 12/31/2999 12/31/2999J1650 54569574200 12/31/2999 4/30/2008J1650 54868511200 12/31/2999 12/31/2999J1650 54868511201 12/31/2999 6/30/2011J1650 54868544000 12/31/2999 6/30/2011J1650 54868544001 12/31/2999 6/30/2011J1650 54868558700 12/31/2999 6/30/2011J1650 54868558701 12/31/2999 6/30/2012J1650 54868583500 12/31/2999 12/31/2999J1650 54868583700 12/31/2999 12/31/2999J1650 58016487201 12/31/2999 11/29/2012J1650 62037083920 12/31/2999 12/31/2999J1650 62037084920 12/31/2999 12/31/2999J1650 62037086120 12/31/2999 12/31/2999J1650 62037086220 12/31/2999 12/31/2999J1650 62037086320 12/31/2999 12/31/2999J1650 62037086420 12/31/2999 12/31/2999J1650 62037086620 12/31/2999 12/31/2999J1650 68115074910 12/31/2999 4/1/2009J1650 68115077410 12/31/2999 4/1/2009J1652 00007323001 12/31/2999 5/17/2011J1652 00007323002 12/31/2999 12/31/2999J1652 00007323011 12/31/2999 12/31/2999J1652 00007323201 12/31/2999 5/17/2011J1652 00007323202 8/31/2013 4/25/2012J1652 00007323211 12/31/2999 12/31/2999J1652 00007323401 12/31/2999 12/31/2999J1652 00007323402 3/31/2014 4/25/2012J1652 00007323411 12/31/2999 12/31/2999J1652 00007323601 12/31/2999 5/17/2011J1652 00007323602 4/30/2014 8/14/2012J1652 00007323611 12/31/2999 12/31/2999J1652 35356007810 12/31/2999 9/5/2012J1652 35356007902 12/31/2999 9/5/2012J1652 35356007910 12/31/2999 9/5/2012J1652 35356008002 12/31/2999 9/5/2012J1652 35356008010 12/31/2999 9/5/2012J1652 35356008102 12/31/2999 9/5/2012

Page 69: *This document is a compilation of NDC:HCPCS combinations

J1652 35356008110 12/31/2999 9/5/2012J1652 54868550100 12/31/2999 6/30/2012J1652 54868550101 12/31/2999 6/30/2011J1652 54868550102 12/31/2999 6/30/2011J1652 54868565200 12/31/2999 6/30/2011J1652 55111067802 12/31/2999 12/31/2999J1652 55111067810 12/31/2999 12/31/2999J1652 55111067902 12/31/2999 12/31/2999J1652 55111067910 12/31/2999 12/31/2999J1652 55111068002 12/31/2999 12/31/2999J1652 55111068010 12/31/2999 12/31/2999J1652 55111068102 12/31/2999 12/31/2999J1652 55111068110 12/31/2999 12/31/2999J1670 13533063402 12/31/2999 12/31/2999J1680 63833891501 12/31/2999 10/24/2011J1720 00009000501 12/31/2999 12/31/2999J1720 00009001103 12/31/2999 12/31/2999J1720 00009001104 12/31/2999 12/31/2999J1720 00009001305 12/31/2999 12/31/2999J1720 00009001306 12/31/2999 12/31/2999J1720 00009001612 12/31/2999 12/31/2999J1720 00009082501 12/31/2999 12/31/2999J1720 00009090013 11/1/2014 1/1/2009J1720 00009090020 2/1/2015 1/1/2009J1720 00009090908 12/31/2999 1/1/2009J1720 00009090916 12/31/2999 7/22/2010J1720 00009091205 12/31/2999 7/22/2010J1720 00009092003 12/31/2999 1/1/2009J1720 00409485605 12/31/2999 12/31/2999J1720 54569138400 12/31/2999 1/31/2003J1725 64011024301 12/31/2999 12/31/2999J1740 00004019109 12/31/2999 12/31/2999J1740 54868582300 12/31/2999 6/30/2010J1741 66220024704 12/31/2999 12/31/2999J1741 66220028708 12/31/2999 12/31/2999J1742 00009379401 12/31/2999 12/31/2999J1742 00009379422 12/31/2999 12/31/2999J1742 00574084001 12/31/2999 12/31/2999J1742 67457036610 12/31/2999 12/31/2999J1743 54092070001 12/31/2999 12/31/2999J1744 54092070202 12/31/2999 12/31/2999J1744 54092070203 12/31/2999 12/31/2999J1745 57894003001 12/31/2999 12/31/2999J1750 00517013410 12/31/2999 12/31/2999J1750 00517023410 12/31/2999 12/31/2999J1750 52544093102 12/31/2999 12/31/2999J1750 54868431900 12/31/2999 6/30/2010

Page 70: *This document is a compilation of NDC:HCPCS combinations

J1756 00517231005 12/31/2999 12/31/2999J1756 00517232510 12/31/2999 12/31/2999J1756 00517234010 12/31/2999 12/31/2999J1756 00517234025 12/31/2999 12/31/2999J1756 49230053010 12/31/2999 12/31/2999J1756 49230053025 12/31/2999 12/31/2999J1756 49230053410 12/31/2999 12/31/2999J1756 49230053425 12/31/2999 12/31/2999J1786 58468198301 12/31/2999 12/31/2999J1786 58468466301 12/31/2999 12/31/2999J1790 00409118701 12/31/2999 12/31/2999J1790 00517970225 12/31/2999 12/31/2999J1790 11098001001 12/31/2999 6/3/2009J1790 11098001002 12/31/2999 6/3/2009J1790 54868389000 12/31/2999 6/30/2002J1800 00143987201 12/31/2999 12/31/2999J1800 00781377795 12/31/2999 12/31/2999J1800 10019014501 12/31/2999 4/28/2009J1800 10019014543 12/31/2999 4/28/2009J1800 54868387300 12/31/2999 12/31/2999J1800 55390000310 12/31/2999 12/31/2999J1800 63323060401 12/31/2999 12/31/2999J1800 66860009002 12/31/2999 8/11/2009J1815 00002751001 12/31/2999 12/31/2999J1815 00002751017 12/31/2999 12/31/2999J1815 00002751101 12/31/2999 12/31/2999J1815 00002751201 12/31/2999 12/31/2999J1815 00002751659 12/31/2999 12/31/2999J1815 00002821501 12/31/2999 12/31/2999J1815 00002821517 12/31/2999 12/31/2999J1815 00002821591 12/31/2999 12/31/2999J1815 00002831501 12/31/2999 12/31/2999J1815 00002831517 12/31/2999 12/31/2999J1815 00002831591 12/31/2999 12/31/2999J1815 00002850101 12/31/2999 12/31/2999J1815 00002871501 12/31/2999 12/31/2999J1815 00002871517 12/31/2999 12/31/2999J1815 00002871591 12/31/2999 12/31/2999J1815 00002872501 8/1/2013 12/10/2010J1815 00002872559 8/1/2013 12/10/2010J1815 00002873001 12/31/2999 12/31/2999J1815 00002873059 12/31/2999 12/31/2999J1815 00002877001 12/31/2999 12/31/2999J1815 00002877059 12/31/2999 12/31/2999J1815 00002879759 12/31/2999 12/31/2999J1815 00002879859 12/31/2999 12/31/2999J1815 00002879959 12/31/2999 12/31/2999

Page 71: *This document is a compilation of NDC:HCPCS combinations

J1815 00088222033 12/31/2999 12/31/2999J1815 00088222052 6/30/2013 2/24/2011J1815 00088250033 12/31/2999 12/31/2999J1815 00088250205 12/31/2999 12/31/2999J1815 00169183302 12/31/2999 12/31/2999J1815 00169183311 12/31/2999 12/31/2999J1815 00169183402 12/31/2999 12/31/2999J1815 00169183411 12/31/2999 12/31/2999J1815 00169183702 12/31/2999 12/31/2999J1815 00169183711 12/31/2999 12/31/2999J1815 00169330312 12/31/2999 12/31/2999J1815 00169368512 12/31/2999 12/31/2999J1815 00169369619 12/31/2999 12/31/2999J1815 00169633910 12/31/2999 12/31/2999J1815 00169643910 12/31/2999 12/31/2999J1815 00169750111 12/31/2999 12/31/2999J1815 35356010200 12/31/2999 12/31/2999J1815 49999099310 12/31/2999 12/31/2999J1815 49999099410 12/31/2999 12/31/2999J1815 54569231800 12/31/2999 12/31/2999J1815 54569231900 12/31/2999 12/31/2999J1815 54569291800 12/31/2999 12/31/2999J1815 54569346700 12/31/2999 12/31/2999J1815 54569383300 12/31/2999 12/31/2999J1815 54569383500 12/31/2999 12/31/2999J1815 54569560500 12/31/2999 12/31/2999J1815 54868142801 12/31/2999 10/5/2001J1815 54868142901 12/31/2999 12/31/2999J1815 54868208901 12/31/2999 10/5/2001J1815 54868238001 12/31/2999 11/30/2011J1815 54868274600 12/31/2999 12/31/2999J1815 54868277700 12/31/2999 6/30/2012J1815 54868347400 12/31/2999 12/31/2999J1815 54868359800 12/31/2999 6/30/2011J1815 54868361900 12/31/2999 12/31/2999J1815 54868438100 12/31/2999 12/31/2999J1815 54868462600 12/31/2999 12/31/2999J1815 54868510800 12/31/2999 12/31/2999J1815 54868520100 12/31/2999 12/31/2999J1815 54868532700 12/31/2999 5/31/2011J1815 54868576500 12/31/2999 4/5/2011J1815 54868583600 12/31/2999 6/30/2012J1815 54868605400 12/31/2999 12/31/2999J1815 58016478801 12/31/2999 11/29/2012J1815 59060023144 12/31/2999 12/19/2003J1815 59060023174 12/31/2999 12/19/2003J1815 68115070905 12/31/2999 4/1/2009

Page 72: *This document is a compilation of NDC:HCPCS combinations

J1815 68115072810 12/31/2999 4/1/2009J1815 68115072905 12/31/2999 4/1/2009J1815 68115074610 12/31/2999 4/1/2009J1815 68115083910 12/31/2999 4/1/2009J1817 00002751001 12/31/2999 12/31/2999J1817 00002751017 12/31/2999 12/31/2999J1817 00002751101 12/31/2999 12/31/2999J1817 00002751659 12/31/2999 12/31/2999J1817 00002821501 12/31/2999 12/31/2999J1817 00002821517 12/31/2999 12/31/2999J1817 00002821591 12/31/2999 12/31/2999J1817 00002831501 12/31/2999 12/31/2999J1817 00002831591 12/31/2999 12/31/2999J1817 00002850101 12/31/2999 12/31/2999J1817 00002871501 12/31/2999 12/31/2999J1817 00002871517 12/31/2999 12/31/2999J1817 00002871591 12/31/2999 12/31/2999J1817 00002872501 8/1/2013 12/10/2010J1817 00002872559 8/1/2013 12/10/2010J1817 00002873001 12/31/2999 12/31/2999J1817 00002873059 12/31/2999 12/31/2999J1817 00002877001 12/31/2999 12/31/2999J1817 00002877059 12/31/2999 12/31/2999J1817 00002879759 12/31/2999 12/31/2999J1817 00002879959 12/31/2999 12/31/2999J1817 00088222033 12/31/2999 12/31/2999J1817 00088250033 12/31/2999 12/31/2999J1817 00088250205 12/31/2999 12/31/2999J1817 00169183311 12/31/2999 12/31/2999J1817 00169183411 12/31/2999 12/31/2999J1817 00169183711 12/31/2999 12/31/2999J1817 00169330312 12/31/2999 12/31/2999J1817 00169368512 12/31/2999 12/31/2999J1817 00169369619 12/31/2999 12/31/2999J1817 00169633910 12/31/2999 12/31/2999J1817 00169750111 12/31/2999 12/31/2999J1817 35356010200 12/31/2999 12/31/2999J1817 49999099310 12/31/2999 12/31/2999J1817 49999099410 12/31/2999 12/31/2999J1817 54569231800 12/31/2999 12/31/2999J1817 54569231900 12/31/2999 12/31/2999J1817 54569291800 12/31/2999 12/31/2999J1817 54569346700 12/31/2999 12/31/2999J1817 54569383300 12/31/2999 12/31/2999J1817 54569383500 12/31/2999 12/31/2999J1817 54569560500 12/31/2999 12/31/2999J1817 54868142801 12/31/2999 10/5/2001

Page 73: *This document is a compilation of NDC:HCPCS combinations

J1817 54868142901 12/31/2999 12/31/2999J1817 54868208901 12/31/2999 10/5/2001J1817 54868238001 12/31/2999 11/30/2011J1817 54868274600 12/31/2999 12/31/2999J1817 54868277700 12/31/2999 6/30/2012J1817 54868347400 12/31/2999 12/31/2999J1817 54868359800 12/31/2999 6/30/2011J1817 54868361900 12/31/2999 12/31/2999J1817 54868438100 12/31/2999 12/31/2999J1817 54868462600 12/31/2999 12/31/2999J1817 54868510800 12/31/2999 12/31/2999J1817 54868520100 12/31/2999 12/31/2999J1817 54868532700 12/31/2999 5/31/2011J1817 54868583600 12/31/2999 6/30/2012J1817 54868605400 12/31/2999 12/31/2999J1817 58016478801 12/31/2999 11/29/2012J1817 59060023144 12/31/2999 12/19/2003J1817 59060023174 12/31/2999 12/19/2003J1817 68115070905 12/31/2999 4/1/2009J1817 68115072810 12/31/2999 4/1/2009J1817 68115072905 12/31/2999 4/1/2009J1817 68115074610 12/31/2999 4/1/2009J1817 68115083910 12/31/2999 4/1/2009J1830 00078056912 12/31/2999 12/31/2999J1830 50419052335 12/31/2999 12/31/2999J1840 63323035903 12/31/2999 1/31/2013J1850 63323035903 12/31/2999 1/31/2013J1885 00074202302 12/31/2999 7/19/2011J1885 00074202349 12/31/2999 7/19/2011J1885 00074203602 12/31/2999 7/19/2011J1885 00074203902 12/31/2999 7/19/2011J1885 00409228723 12/31/2999 12/31/2999J1885 00409228731 12/31/2999 12/31/2999J1885 00409228761 12/31/2999 12/31/2999J1885 00409228821 12/31/2999 12/31/2999J1885 00409228831 12/31/2999 12/31/2999J1885 00409379301 12/31/2999 12/31/2999J1885 00409379349 12/31/2999 12/31/2999J1885 00409379501 12/31/2999 12/31/2999J1885 00409379549 12/31/2999 12/31/2999J1885 00409379561 12/31/2999 12/31/2999J1885 00409379601 12/31/2999 12/31/2999J1885 00409379649 12/31/2999 12/31/2999J1885 00517060125 12/31/2999 12/1/2011J1885 00517080125 12/31/2999 12/1/2011J1885 00517090225 12/31/2999 12/1/2011J1885 00641604125 12/31/2999 12/31/2999

Page 74: *This document is a compilation of NDC:HCPCS combinations

J1885 00641604225 12/31/2999 12/31/2999J1885 00641604325 12/31/2999 12/31/2999J1885 10019002109 12/31/2999 8/30/2008J1885 10019002209 12/31/2999 10/30/2008J1885 10019002232 12/31/2999 9/30/2008J1885 10019002902 10/31/2013 7/25/2012J1885 10019003003 5/31/2013 7/25/2012J1885 10019003004 8/31/2013 7/25/2012J1885 10019003012 5/31/2013 5/31/2013J1885 10019003017 8/31/2013 7/25/2012J1885 21695058810 12/31/2999 12/31/2999J1885 21695058825 12/31/2999 12/31/2999J1885 49999041601 12/31/2999 12/31/2999J1885 49999041602 12/31/2999 7/2/2009J1885 49999067001 12/31/2999 12/31/2999J1885 54569495400 12/31/2999 1/31/2003J1885 54569495500 12/31/2999 1/31/2003J1885 54569518800 12/31/2999 1/31/2003J1885 54569518900 12/31/2999 12/31/2999J1885 55390048001 12/31/2999 12/31/2999J1885 55390048101 12/31/2999 12/31/2999J1885 55390048102 12/31/2999 12/31/2999J1885 55390048110 12/31/2999 12/31/2999J1885 60505071001 12/31/2999 8/1/2008J1885 63323016101 12/31/2999 12/31/2999J1885 63323016201 12/31/2999 12/31/2999J1885 63323016202 12/31/2999 12/31/2999J1885 64679075701 12/31/2999 12/31/2999J1885 64679075702 12/31/2999 12/31/2999J1885 64679075801 12/31/2999 12/31/2999J1885 64679075802 12/31/2999 12/31/2999J1885 64679075804 12/31/2999 12/31/2999J1885 64679075806 12/31/2999 12/31/2999J1885 66860008403 12/31/2999 12/31/2999J1885 66860008503 12/31/2999 12/31/2999J1885 66860008603 12/31/2999 12/31/2999J1930 15054006001 12/31/2999 12/31/2999J1930 15054009001 12/31/2999 12/31/2999J1930 15054012001 12/31/2999 12/31/2999J1930 15054012002 12/31/2999 12/15/2009J1931 58468007001 12/31/2999 12/31/2999J1940 00409163910 12/31/2999 12/31/2999J1940 00409610202 12/31/2999 12/31/2999J1940 00409610204 12/31/2999 12/31/2999J1940 00409610210 12/31/2999 12/31/2999J1940 00409963104 12/31/2999 12/31/2999J1940 00517570225 12/31/2999 12/31/2999

Page 75: *This document is a compilation of NDC:HCPCS combinations

J1940 00517570425 12/31/2999 12/31/2999J1940 00517571025 12/31/2999 12/31/2999J1940 21695072125 12/31/2999 12/31/2999J1940 54868229900 12/31/2999 12/31/2999J1940 54868364500 12/31/2999 6/4/2007J1940 54868499800 12/31/2999 6/3/2011J1940 63323028002 12/31/2999 12/31/2999J1940 63323028004 12/31/2999 12/31/2999J1940 63323028010 12/31/2999 12/31/2999J1945 50419015057 12/31/2999 12/31/2999J1950 00074210803 12/31/2999 12/31/2999J1950 00074228203 12/31/2999 12/31/2999J1950 00074244003 12/31/2999 12/31/2999J1950 00074334603 12/31/2999 12/31/2999J1950 00074364103 12/31/2999 12/31/2999J1950 00074364203 12/31/2999 12/31/2999J1950 00074366303 12/31/2999 12/31/2999J1950 00074368303 12/31/2999 12/31/2999J1950 00074377903 12/31/2999 12/31/2999J1950 00074969403 12/31/2999 12/31/2999J1950 54569344400 12/31/2999 1/31/2003J1950 54868556800 12/31/2999 6/30/2011J1953 00143967310 12/31/2999 12/31/2999J1953 00409188602 12/31/2999 12/31/2999J1953 00517360525 12/31/2999 12/31/2999J1953 14789040005 12/31/2999 2/23/2013J1953 25021078005 12/31/2999 12/31/2999J1953 39822400001 12/31/2999 12/31/2999J1953 50474000263 12/31/2999 12/31/2999J1953 62756051344 12/31/2999 12/31/2999J1953 63323040009 12/31/2999 12/31/2999J1953 67457025510 12/31/2999 12/31/2999J1953 67457026510 12/31/2999 12/31/2999J1953 67457026610 12/31/2999 12/31/2999J1955 00517104525 12/31/2999 12/31/2999J1955 00703040402 12/31/2999 12/31/2999J1955 00703040502 12/31/2999 12/31/2999J1955 54482014701 12/31/2999 12/31/2999J1955 55390013605 12/31/2999 12/31/2999J1956 00143972001 12/31/2999 12/31/2999J1956 00143972024 12/31/2999 12/31/2999J1956 00143972101 12/31/2999 12/31/2999J1956 00143972201 12/31/2999 12/31/2999J1956 00781334109 12/31/2999 12/31/2999J1956 00781334209 12/31/2999 12/31/2999J1956 00781334309 12/31/2999 12/31/2999J1956 17478010720 12/31/2999 12/31/2999

Page 76: *This document is a compilation of NDC:HCPCS combinations

J1956 17478010730 12/31/2999 12/31/2999J1956 23155020131 12/31/2999 12/31/2999J1956 23155020132 12/31/2999 12/31/2999J1956 25021013020 12/31/2999 12/31/2999J1956 25021013030 12/31/2999 12/31/2999J1956 25021013267 12/31/2999 12/31/2999J1956 25021013268 12/31/2999 12/31/2999J1956 25021013281 12/31/2999 12/31/2999J1956 25021013282 12/31/2999 12/31/2999J1956 25021013283 12/31/2999 12/31/2999J1956 25021082581 12/31/2999 12/31/2999J1956 25021082582 12/31/2999 12/31/2999J1956 25021082583 12/31/2999 12/31/2999J1956 50458016420 1/1/2013 10/31/2011J1956 50458016530 4/1/2013 10/31/2011J1956 50458016601 12/31/2999 12/31/2999J1956 50458016701 12/31/2999 12/31/2999J1956 50458016801 12/31/2999 12/31/2999J1956 54569467700 12/31/2999 6/1/2003J1956 63323035550 12/31/2999 12/31/2999J1956 63323035560 12/31/2999 12/31/2999J1956 63323035565 12/31/2999 12/31/2999J1980 00091153605 12/31/2999 4/16/2009J1980 68220011105 12/31/2999 12/31/2999J2001 00186015501 5/31/2013 7/13/2010J2001 00186024444 12/31/2999 2/1/2013J2001 00264959410 12/31/2999 12/31/2999J2001 00264959420 12/31/2999 12/31/2999J2001 00264959810 12/31/2999 2/29/2004J2001 00264959820 12/31/2999 12/31/2999J2001 00338040903 12/31/2999 12/31/2999J2001 00338041102 12/31/2999 12/31/2999J2001 00409132305 12/31/2999 12/31/2999J2001 00409206605 12/31/2999 12/31/2999J2001 00409405601 12/31/2999 12/31/2999J2001 00409427001 12/31/2999 12/31/2999J2001 00409427501 6/1/2013 6/1/2013J2001 00409427601 12/31/2999 12/31/2999J2001 00409427602 12/31/2999 12/31/2999J2001 00409427701 12/31/2999 12/31/2999J2001 00409427702 12/31/2999 12/31/2999J2001 00409427801 12/31/2999 12/31/2999J2001 00409427902 12/31/2999 12/31/2999J2001 00409428201 12/31/2999 12/31/2999J2001 00409428202 12/31/2999 12/31/2999J2001 00409428301 12/31/2999 12/31/2999J2001 00409471302 12/31/2999 12/31/2999

Page 77: *This document is a compilation of NDC:HCPCS combinations

J2001 00409471332 12/31/2999 12/31/2999J2001 00409477601 12/31/2999 12/31/2999J2001 00409490334 12/31/2999 12/31/2999J2001 00409490434 12/31/2999 12/31/2999J2001 00409793124 12/31/2999 12/31/2999J2001 00409793132 12/31/2999 12/31/2999J2001 00409793932 12/31/2999 12/31/2999J2001 00409913705 12/31/2999 12/31/2999J2001 00548339000 9/30/2014 11/20/2012J2001 54569208100 12/31/2999 1/31/2003J2001 54868179500 12/31/2999 6/30/2012J2001 54868179801 12/31/2999 6/30/2012J2001 54868206400 12/31/2999 6/30/2012J2001 54868206401 12/31/2999 6/30/2012J2001 54868339200 12/31/2999 6/30/2011J2001 58016484001 12/31/2999 11/29/2012J2001 58016933101 12/31/2999 11/29/2012J2001 63323020102 12/31/2999 12/31/2999J2001 63323020110 12/31/2999 12/31/2999J2001 63323020202 12/31/2999 12/31/2999J2001 63323020805 12/31/2999 12/31/2999J2001 63323048520 10/30/2014 4/26/2011J2001 63323048550 3/30/2015 9/27/2011J2001 63323048610 5/30/2014 9/21/2011J2001 63323048620 12/30/2014 9/8/2011J2001 63323049089 12/31/2999 12/31/2999J2001 63323049150 11/30/2013 1/6/2011J2001 63323049202 4/30/2015 8/2/2011J2001 63323049205 3/30/2014 1/20/2011J2001 63323049230 6/30/2014 1/21/2011J2001 63323049231 12/31/2999 12/31/2999J2001 63323049280 12/31/2999 12/31/2999J2001 63323049289 12/31/2999 12/31/2999J2001 63323049297 12/31/2999 12/31/2999J2001 63323049397 12/31/2999 12/31/2999J2001 63323049502 12/30/2014 11/30/2010J2001 63323049505 1/30/2015 4/1/2011J2001 63323049680 12/31/2999 12/31/2999J2001 63323049889 12/31/2999 12/31/2999J2010 00009055501 12/31/2999 12/31/2999J2010 00009055502 12/31/2999 12/31/2999J2010 54569138700 12/31/2999 1/31/2003J2020 00009513701 12/31/2999 12/31/2999J2020 00009514001 12/31/2999 12/31/2999J2060 00054353244 12/31/2999 12/31/2999J2060 00074153901 12/31/2999 7/19/2011J2060 00074153921 12/31/2999 7/19/2011

Page 78: *This document is a compilation of NDC:HCPCS combinations

J2060 00074677601 12/31/2999 5/2/2011J2060 00074677701 12/31/2999 5/2/2011J2060 00409153931 12/31/2999 12/31/2999J2060 00409198501 12/31/2999 6/12/2009J2060 00409198510 12/31/2999 2/1/2009J2060 00409198530 12/31/2999 12/31/2999J2060 00409677802 12/31/2999 12/31/2999J2060 00409677862 12/31/2999 12/31/2999J2060 00409677902 12/31/2999 12/31/2999J2060 00409678002 12/31/2999 12/31/2999J2060 00409678102 12/31/2999 12/31/2999J2060 00641600010 12/31/2999 12/31/2999J2060 00641600125 12/31/2999 12/31/2999J2060 00641600210 12/31/2999 12/31/2999J2060 00641600325 12/31/2999 12/31/2999J2060 00641604425 12/31/2999 12/31/2999J2060 00641604525 12/31/2999 12/31/2999J2060 00641604610 12/31/2999 12/31/2999J2060 00641604710 12/31/2999 12/31/2999J2060 00641604825 12/31/2999 12/31/2999J2060 00641604925 12/31/2999 12/31/2999J2060 00641605010 12/31/2999 12/31/2999J2060 00641605110 12/31/2999 12/31/2999J2060 10019010201 2/28/2014 4/6/2012J2060 10019010210 8/31/2013 4/6/2012J2060 10019010237 8/31/2013 4/6/2012J2060 10019010239 2/28/2014 4/6/2012J2060 10019010301 1/31/2014 4/6/2012J2060 10019010310 12/31/2013 4/6/2012J2060 10019010339 1/31/2014 4/6/2012J2060 10019010501 11/30/2013 4/6/2012J2060 10019010502 9/30/2013 4/6/2012J2060 10019010544 11/30/2013 4/6/2012J2060 10019010571 9/30/2013 4/6/2012J2060 10019010601 1/31/2014 4/6/2012J2060 10019010602 12/31/2013 4/6/2012J2060 10019010644 1/31/2014 4/6/2012J2060 10019010671 12/31/2013 12/31/2999J2060 17478004001 12/31/2999 12/31/2999J2060 54868240701 12/31/2999 6/30/2001J2060 54868356600 12/31/2999 6/30/2011J2060 54868356601 12/31/2999 6/30/2011J2060 54868356602 12/31/2999 6/30/2011J2060 55390016810 12/31/2999 5/2/2011J2060 55390016910 12/31/2999 5/2/2011J2060 55390017010 12/31/2999 5/2/2011J2060 55390017110 12/31/2999 5/2/2011

Page 79: *This document is a compilation of NDC:HCPCS combinations

J2060 60977011201 2/28/2014 4/6/2012J2060 60977011202 12/31/2999 3/28/2009J2060 60977011271 12/31/2999 3/28/2009J2060 60977011281 2/28/2014 4/6/2012J2060 60977011301 1/31/2014 4/6/2012J2060 60977011302 12/31/2013 4/6/2012J2060 60977011371 12/31/2013 4/6/2012J2060 60977011381 1/31/2014 4/6/2012J2060 60977011601 6/30/2013 4/6/2012J2060 60977011602 6/30/2013 4/6/2012J2150 00409403101 12/31/2999 12/31/2999J2150 00517405025 12/31/2999 12/31/2999J2150 63323002425 12/31/2999 12/31/2999J2170 15054104005 12/31/2999 12/31/2999J2175 00024033704 5/31/2014 5/24/2012J2175 00054459625 12/31/2999 12/31/2999J2175 00409117630 12/31/2999 12/31/2999J2175 00409117830 12/31/2999 12/31/2999J2175 00409117930 12/31/2999 12/31/2999J2175 00409118069 12/31/2999 12/31/2999J2175 00409118130 12/31/2999 12/31/2999J2175 00409120120 12/31/2999 12/31/2999J2175 00409120301 12/31/2999 12/31/2999J2175 00409125301 12/31/2999 12/31/2999J2175 00409125401 12/31/2999 12/31/2999J2175 00409125502 12/31/2999 12/31/2999J2175 00409125601 12/31/2999 12/31/2999J2175 00409603004 12/31/2999 12/31/2999J2175 00555038202 12/31/2999 12/31/2999J2175 00603441621 12/31/2999 12/31/2999J2175 00641605225 12/31/2999 12/31/2999J2175 00641605325 12/31/2999 12/31/2999J2175 00641605425 12/31/2999 12/31/2999J2175 10019015901 2/28/2013 10/7/2011J2175 10019015944 2/28/2013 10/7/2011J2175 10019016001 4/30/2013 12/19/2011J2175 10019016044 4/30/2013 12/19/2011J2175 10019016201 3/31/2013 12/1/2011J2175 10019016244 3/31/2013 12/1/2011J2175 54868061600 12/31/2999 6/30/2011J2175 54868323001 12/31/2999 6/30/2011J2175 54868361000 12/31/2999 6/30/2011J2175 54868475100 12/31/2999 6/30/2011J2175 54868475101 12/31/2999 6/30/2011J2175 54868580800 12/31/2999 12/31/2999J2175 57664047108 12/31/2999 12/31/2999J2175 61553017041 12/31/2999 12/31/2999

Page 80: *This document is a compilation of NDC:HCPCS combinations

J2175 61553017248 12/31/2999 12/31/2999J2175 61553017348 12/31/2999 12/31/2999J2185 00310032130 12/31/2999 12/31/2999J2185 00310032165 2/18/2015 10/22/2012J2185 00310032520 12/31/2999 12/31/2999J2185 00310032564 1/31/2014 10/22/2012J2185 00409350501 12/31/2999 12/31/2999J2185 00409350601 12/31/2999 12/31/2999J2185 00781326595 12/31/2999 12/31/2999J2185 00781326795 12/31/2999 12/31/2999J2185 63323050720 12/31/2999 12/31/2999J2185 63323050721 12/31/2999 12/31/2999J2185 63323050830 12/31/2999 12/31/2999J2185 63323050831 12/31/2999 12/31/2999J2210 00078005303 3/31/2015 4/16/2012J2210 00517074020 12/31/2999 12/31/2999J2210 17478050101 12/31/2999 12/31/2999J2210 54569236200 12/31/2999 1/31/2003J2212 00008121801 8/31/2013 9/7/2011J2212 00008251302 7/31/2013 9/7/2011J2212 65649055102 12/31/2999 12/31/2999J2212 65649055103 12/31/2999 12/31/2999J2212 65649055107 12/31/2999 12/31/2999J2212 65649055204 12/31/2999 12/31/2999J2212 65649055305 12/31/2999 12/31/2999J2248 00469321110 12/31/2999 12/31/2999J2248 00469325010 12/31/2999 12/31/2999J2250 00409230505 12/31/2999 12/31/2999J2250 00409230517 12/31/2999 12/31/2999J2250 00409230521 12/31/2999 12/31/2999J2250 00409230550 12/31/2999 12/31/2999J2250 00409230612 12/31/2999 12/31/2999J2250 00409230662 12/31/2999 12/31/2999J2250 00409230760 12/31/2999 12/31/2999J2250 00409230801 12/31/2999 12/31/2999J2250 00409230802 12/31/2999 12/31/2999J2250 00409230849 12/31/2999 12/31/2999J2250 00409230850 12/31/2999 12/31/2999J2250 00409258705 12/31/2999 12/31/2999J2250 00409258753 12/31/2999 12/31/2999J2250 00409259603 12/31/2999 12/31/2999J2250 00409259605 12/31/2999 12/31/2999J2250 00409259652 12/31/2999 12/31/2999J2250 00409259653 12/31/2999 12/31/2999J2250 00641605610 12/31/2999 12/31/2999J2250 00641605710 12/31/2999 12/31/2999J2250 00641605725 12/31/2999 12/31/2999

Page 81: *This document is a compilation of NDC:HCPCS combinations

J2250 00641605910 12/31/2999 12/31/2999J2250 00641606010 12/31/2999 12/31/2999J2250 00641606110 12/31/2999 12/31/2999J2250 00641606125 12/31/2999 12/31/2999J2250 00641606310 12/31/2999 12/31/2999J2250 00641606325 12/31/2999 12/31/2999J2250 10019002706 6/30/2013 2/8/2012J2250 10019002709 6/30/2013 2/8/2012J2250 10019002710 5/31/2013 2/8/2012J2250 10019002739 5/31/2013 2/8/2012J2250 10019002764 6/30/2013 2/8/2012J2250 10019002801 10/31/2013 2/8/2012J2250 10019002804 11/30/2013 2/8/2012J2250 10019002805 10/31/2013 2/8/2012J2250 10019002810 10/31/2013 2/8/2012J2250 10019002837 10/31/2013 2/8/2012J2250 10019002839 10/31/2013 2/8/2012J2250 10019002859 10/31/2013 2/8/2012J2250 17478052302 12/31/2999 12/31/2999J2250 17478052310 12/31/2999 12/31/2999J2250 17478052355 12/31/2999 12/31/2999J2250 17478052401 12/31/2999 12/31/2999J2250 17478052402 12/31/2999 12/31/2999J2250 17478052405 12/31/2999 12/31/2999J2250 17478052410 12/31/2999 12/31/2999J2250 25021065502 12/31/2999 12/31/2999J2250 25021065505 12/31/2999 12/31/2999J2250 25021065601 12/31/2999 12/31/2999J2250 25021065602 12/31/2999 12/31/2999J2250 25021066010 12/31/2999 12/31/2999J2250 25021066105 12/31/2999 12/31/2999J2250 25021066110 12/31/2999 12/31/2999J2250 35356048210 12/31/2999 10/16/2012J2250 54569511600 12/31/2999 12/31/2999J2250 54569511601 12/31/2999 12/31/2999J2250 54569525500 12/31/2999 1/31/2003J2250 54569525501 12/31/2999 1/31/2003J2250 54868458000 12/31/2999 7/31/2011J2250 54868571100 12/31/2999 12/31/2999J2250 55390012510 12/31/2999 12/31/2999J2250 55390012605 12/31/2999 12/31/2999J2250 55390012610 12/31/2999 12/31/2999J2250 55390013702 12/31/2999 12/31/2999J2250 55390013705 12/31/2999 12/31/2999J2250 55390013801 12/31/2999 12/31/2999J2250 55390013802 12/31/2999 12/31/2999J2250 57664063343 12/31/2999 12/31/2999

Page 82: *This document is a compilation of NDC:HCPCS combinations

J2250 57664063444 12/31/2999 12/31/2999J2250 57664063445 12/31/2999 12/31/2999J2250 60505071101 12/31/2999 5/7/2003J2250 60505071102 12/31/2999 2/19/2003J2250 60505071103 12/31/2999 5/7/2003J2250 60505071201 12/31/2999 1/15/2003J2250 60505071202 12/31/2999 12/5/2002J2250 60505071203 12/31/2999 1/22/2003J2250 60505071204 12/31/2999 5/7/2003J2250 63323041110 12/31/2999 12/31/2999J2250 63323041112 12/31/2999 12/31/2999J2250 63323041125 12/31/2999 12/31/2999J2250 63323041202 12/31/2999 12/31/2999J2250 63323041205 12/31/2999 12/31/2999J2250 63323041210 12/31/2999 12/31/2999J2250 63323041225 12/31/2999 12/31/2999J2250 65293041125 12/31/2999 12/31/2999J2250 65293041210 12/31/2999 12/31/2999J2250 65293041310 12/31/2999 12/31/2999J2250 65293041410 12/31/2999 12/31/2999J2250 65293041510 12/31/2999 12/31/2999J2250 65293041625 12/31/2999 12/31/2999J2250 65293041725 12/31/2999 12/31/2999J2250 66758001802 12/31/2999 6/3/2008J2250 66758001902 12/31/2999 6/3/2008J2250 66860013002 12/31/2999 12/31/2999J2250 66860013202 12/31/2999 12/31/2999J2250 66860013302 12/31/2999 12/31/2999J2250 66860014002 12/31/2999 12/31/2999J2250 66860014102 12/31/2999 12/31/2999J2250 66860014202 12/31/2999 12/31/2999J2250 66860014502 12/31/2999 12/31/2999J2250 66860014602 12/31/2999 12/31/2999J2260 00338601048 12/31/2999 12/31/2999J2260 00338601137 12/31/2999 12/31/2999J2260 00409277502 12/31/2999 11/1/2006J2260 00409277602 12/31/2999 12/31/2999J2260 00409277623 12/31/2999 12/31/2999J2260 00641606510 12/31/2999 2/1/2013J2260 00641606710 12/31/2999 2/1/2013J2260 10019007001 6/30/2013 12/19/2011J2260 10019007002 6/30/2013 12/19/2011J2260 10019007010 6/30/2013 12/19/2011J2260 10019007020 6/30/2013 12/19/2011J2260 55390001910 12/31/2999 12/31/2999J2260 55390002010 12/31/2999 12/31/2999J2260 55390002101 12/31/2999 12/31/2999

Page 83: *This document is a compilation of NDC:HCPCS combinations

J2260 55390007410 12/31/2999 4/18/2013J2260 55390007510 2/29/2012 4/18/2013J2260 55390007601 2/29/2012 4/18/2013J2260 55390007801 12/31/2999 12/31/2999J2260 55390007901 12/31/2999 12/31/2999J2260 63323061710 12/31/2999 12/31/2999J2260 63323061720 12/31/2999 12/31/2999J2260 63323061750 12/31/2999 12/31/2999J2260 67457016020 12/31/2999 11/28/2006J2265 54531010001 12/31/2999 12/31/2999J2270 00074126021 12/31/2999 7/19/2011J2270 00074126421 12/31/2999 7/19/2011J2270 00409125830 9/1/2013 12/31/2999J2270 00409126069 10/1/2013 12/31/2999J2270 00409126130 3/1/2014 12/31/2999J2270 00409126431 6/1/2013 6/1/2013J2270 00409176230 11/1/2013 12/31/2999J2270 00409189001 12/31/2999 12/31/2999J2270 00409189101 12/31/2999 12/31/2999J2270 00409189201 12/31/2999 12/31/2999J2270 00409189301 12/31/2999 12/31/2999J2270 00409189401 12/31/2999 12/31/2999J2270 00409381512 12/31/2999 12/31/2999J2270 00409602804 12/31/2999 12/31/2999J2270 00409617714 12/31/2999 12/31/2999J2270 00409617914 12/31/2999 12/31/2999J2270 00548191125 12/31/2999 12/31/2999J2270 00548290100 12/31/2999 6/4/2007J2270 00641017025 12/31/2999 5/25/2004J2270 10019017639 10/31/2013 2/8/2012J2270 10019017644 10/31/2013 2/8/2012J2270 10019017739 1/31/2013 2/8/2012J2270 10019017744 1/31/2013 2/8/2012J2270 10019017836 7/31/2013 2/8/2012J2270 10019017839 11/30/2013 2/8/2012J2270 10019017844 11/30/2013 2/8/2012J2270 10019017862 7/31/2013 2/8/2012J2270 10019017936 10/31/2013 2/8/2012J2270 10019017939 1/31/2013 2/8/2012J2270 10019017944 1/31/2013 2/8/2012J2270 45183085901 12/31/2999 12/31/2999J2270 45183087741 12/31/2999 12/31/2999J2270 45183087948 12/31/2999 12/31/2999J2270 54868418900 12/31/2999 1/13/2012J2270 54868475200 12/31/2999 6/30/2011J2270 61553017741 12/31/2999 12/31/2999J2270 61553017848 12/31/2999 12/31/2999

Page 84: *This document is a compilation of NDC:HCPCS combinations

J2270 61553017948 12/31/2999 12/31/2999J2270 61553018102 12/31/2999 12/31/2999J2270 61553018348 12/31/2999 12/31/2999J2270 61553018502 12/31/2999 12/31/2999J2270 61553018667 12/31/2999 12/31/2999J2270 61553018775 12/31/2999 12/31/2999J2270 61553025901 12/31/2999 12/31/2999J2270 61553061441 12/31/2999 12/31/2999J2270 61553061502 12/31/2999 12/31/2999J2270 61553065376 12/31/2999 12/31/2999J2271 00074126021 12/31/2999 7/19/2011J2271 00074126421 12/31/2999 7/19/2011J2271 00338269075 12/31/2999 2/28/2009J2271 00409113403 12/31/2999 12/31/2999J2271 00409113405 12/31/2999 12/31/2999J2271 00409113502 12/31/2999 12/31/2999J2271 00409126431 6/1/2013 6/1/2013J2271 00409176230 11/1/2013 12/31/2999J2271 00409202902 12/31/2999 12/31/2999J2271 00409602804 12/31/2999 12/31/2999J2271 00409617714 12/31/2999 12/31/2999J2271 00409617914 12/31/2999 12/31/2999J2271 00548191125 12/31/2999 12/31/2999J2271 00548290100 12/31/2999 6/4/2007J2271 00641017025 12/31/2999 5/25/2004J2271 10019017639 10/31/2013 2/8/2012J2271 10019017739 1/31/2013 2/8/2012J2271 10019017836 7/31/2013 2/8/2012J2271 10019017839 11/30/2013 2/8/2012J2271 10019017862 7/31/2013 2/8/2012J2271 10019017936 10/31/2013 2/8/2012J2271 10019017939 1/31/2013 2/8/2012J2271 10019017944 1/31/2013 2/8/2012J2271 10019017963 10/31/2013 2/8/2012J2271 54868418900 12/31/2999 1/13/2012J2271 54868475200 12/31/2999 6/30/2011J2271 61553064975 12/31/2999 12/31/2999J2271 61553065176 12/31/2999 12/31/2999J2275 00186115312 12/31/2999 12/1/2009J2275 00409113502 12/31/2999 12/31/2999J2275 00409125830 9/1/2013 12/31/2999J2275 00409202902 12/31/2999 12/31/2999J2275 00409381412 12/31/2999 12/31/2999J2275 00409381512 12/31/2999 12/31/2999J2275 00641601910 12/31/2999 12/31/2999J2275 00641602010 12/31/2999 12/31/2999J2275 00641603901 12/31/2999 12/31/2999

Page 85: *This document is a compilation of NDC:HCPCS combinations

J2275 00641604001 12/31/2999 12/31/2999J2275 60977001602 2/28/2015 7/3/2012J2275 60977001673 2/28/2015 7/3/2012J2275 60977001701 2/28/2015 7/3/2012J2275 60977001773 2/28/2015 7/3/2012J2275 60977011401 10/31/2014 7/25/2012J2275 60977011474 10/31/2014 7/25/2012J2275 60977011501 9/30/2014 7/25/2012J2275 60977011574 9/30/2014 7/25/2012J2275 63323029110 12/31/2999 12/31/2999J2275 63323029180 12/31/2999 12/31/2999J2275 63323029210 12/31/2999 12/31/2999J2275 63323029280 12/31/2999 12/31/2999J2275 63323029297 3/30/2013 7/30/2010J2278 18860072010 12/31/2999 12/31/2999J2278 18860072210 12/31/2999 12/31/2999J2278 18860072310 12/31/2999 12/31/2999J2278 59075072010 4/1/2013 1/31/2011J2278 59075072210 4/1/2013 1/31/2011J2280 00085173701 12/31/2999 12/31/2999J2300 00409146301 12/31/2999 12/31/2999J2300 00409146349 12/31/2999 12/31/2999J2300 00409146401 12/31/2999 12/31/2999J2300 00409146501 12/31/2999 12/31/2999J2300 00409146549 12/31/2999 12/31/2999J2300 00409146701 12/31/2999 12/31/2999J2300 49999042610 12/31/2999 9/16/2005J2300 54569411200 12/31/2999 1/31/2003J2300 54569579500 12/31/2999 12/31/2999J2300 54868347100 12/31/2999 9/15/2005J2300 54868360800 12/31/2999 6/30/2010J2300 54868360801 12/31/2999 6/30/2010J2300 54868360900 12/31/2999 11/30/2006J2300 54868368600 12/31/2999 5/21/2007J2300 54868368601 12/31/2999 5/21/2007J2300 58016477001 12/31/2999 11/29/2012J2300 58016938401 12/31/2999 11/29/2012J2310 00074121301 12/31/2999 5/2/2011J2310 00409121501 12/31/2999 12/31/2999J2310 00409121901 12/31/2999 12/31/2999J2310 00409178269 12/31/2999 12/31/2999J2310 00548146900 1/31/2014 4/5/2012J2310 00548336900 2/28/2014 4/13/2012J2310 54569524700 12/31/2999 12/31/2999J2310 54868206200 12/31/2999 6/30/2012J2315 65757030001 12/31/2999 12/31/2999J2323 59075073015 12/31/2999 12/31/2999

Page 86: *This document is a compilation of NDC:HCPCS combinations

J2325 65847020525 12/31/2999 12/31/2999J2353 00078034061 12/31/2999 12/31/2999J2353 00078034161 12/31/2999 12/31/2999J2353 00078034261 12/31/2999 12/31/2999J2354 00078018001 12/31/2999 12/31/2999J2354 00078018101 12/31/2999 12/31/2999J2354 00078018201 12/31/2999 12/31/2999J2354 00078018325 12/31/2999 12/31/2999J2354 00078018425 12/31/2999 12/31/2999J2354 00703330104 12/31/2999 12/31/2999J2354 00703331104 12/31/2999 12/31/2999J2354 00703332104 12/31/2999 12/31/2999J2354 00703333301 12/31/2999 12/31/2999J2354 00703334301 12/31/2999 12/31/2999J2354 00781316475 12/31/2999 12/31/2999J2354 00781316575 12/31/2999 12/31/2999J2354 00781916475 6/29/2014 7/18/2012J2354 00781916575 11/17/2014 7/18/2012J2354 00781916671 12/31/2999 12/31/2999J2354 00781916695 12/31/2999 12/31/2999J2354 00781916771 12/31/2999 12/31/2999J2354 00781916795 12/31/2999 12/31/2999J2354 00781916871 12/31/2999 12/31/2999J2354 00781916895 12/31/2999 12/31/2999J2354 25021045101 12/31/2999 12/31/2999J2354 55390016010 12/31/2999 12/31/2999J2354 55390016110 12/31/2999 12/31/2999J2354 55390016210 12/31/2999 12/31/2999J2354 55390016301 12/31/2999 12/31/2999J2354 55390016401 12/31/2999 12/31/2999J2354 55390037510 4/30/2013 6/7/2012J2354 55390037610 1/31/2013 6/7/2012J2354 55390037701 4/30/2013 6/7/2012J2354 62756009444 12/31/2999 12/31/2999J2354 62756034844 12/31/2999 12/31/2999J2354 62756034944 12/31/2999 12/31/2999J2354 62756035040 12/31/2999 12/31/2999J2354 62756035144 12/31/2999 12/31/2999J2354 62756035240 12/31/2999 12/31/2999J2354 63323036501 12/31/2999 12/31/2999J2354 63323037601 12/31/2999 12/31/2999J2354 63323037701 12/31/2999 12/31/2999J2354 63323037805 12/31/2999 12/31/2999J2354 63323037905 12/31/2999 12/31/2999J2354 67457023901 12/31/2999 12/31/2999J2354 67457024501 12/31/2999 12/31/2999J2354 67457024601 12/31/2999 12/31/2999

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J2355 54868556900 12/31/2999 6/30/2011J2355 58394000401 12/31/2999 9/2/2009J2355 58394000402 12/31/2999 6/15/2007J2355 58394000408 12/31/2999 12/31/2999J2357 50242004062 12/31/2999 12/31/2999J2358 00002763511 12/31/2999 12/31/2999J2358 00002763611 12/31/2999 12/31/2999J2358 00002763711 12/31/2999 12/31/2999J2360 00089054006 12/31/2999 5/1/2011J2360 00591322202 12/31/2999 12/31/2999J2360 00591322247 12/31/2999 12/31/2999J2360 17478053802 12/31/2999 12/31/2999J2360 25021065102 12/31/2999 12/31/2999J2360 29336054006 2/28/2013 12/2/2011J2360 52959017906 12/31/2999 5/1/2012J2360 54569189401 12/31/2999 1/31/2003J2360 55390005910 12/31/2999 12/31/2999J2370 00409180001 8/1/2014 12/31/2999J2370 00517029925 12/31/2999 12/31/2999J2370 00517040525 12/31/2999 12/31/2999J2370 00641608825 12/31/2999 2/15/2013J2370 00641614225 12/31/2999 12/31/2999J2370 10019016312 7/31/2013 12/19/2011J2370 10019016339 7/31/2013 12/19/2011J2370 54868571600 12/31/2999 12/31/2999J2370 66758001602 12/31/2999 4/1/2009J2370 66758001603 12/31/2999 12/31/2999J2370 66758001604 12/31/2999 12/31/2999J2370 66758001701 12/31/2999 12/31/2999J2400 00186097166 12/31/2999 5/4/2010J2400 00186099266 12/31/2999 2/1/2013J2400 00409416901 1/1/2013 1/1/2013J2400 00409417001 7/1/2013 12/31/2999J2400 55390040320 12/31/2999 12/31/2999J2400 55390040420 12/31/2999 12/31/2999J2400 63323047537 12/31/2999 12/31/2999J2400 63323047637 12/31/2999 12/31/2999J2400 63323047720 12/31/2999 2/29/2012J2400 63323047727 12/31/2999 12/31/2999J2400 63323047827 12/31/2999 12/31/2999J2405 00054006447 12/31/2999 12/31/2999J2405 00069134002 12/31/2999 12/31/2999J2405 00069134016 12/31/2999 12/31/2999J2405 00143977106 12/31/2999 5/13/2011J2405 00143989001 12/31/2999 12/31/2999J2405 00143989105 12/31/2999 4/10/2012J2405 00143989125 12/31/2999 12/31/2999

Page 88: *This document is a compilation of NDC:HCPCS combinations

J2405 00173044200 12/31/2999 12/31/2999J2405 00409112012 12/31/2999 12/31/2999J2405 00409112062 3/1/2013 5/10/2012J2405 00409475501 12/31/2999 12/31/2999J2405 00409475502 12/31/2999 12/31/2999J2405 00409475503 12/31/2999 12/31/2999J2405 00409475561 12/31/2999 1/1/2009J2405 00409475563 12/31/2999 12/31/2999J2405 00409475901 12/31/2999 12/31/2999J2405 00641607825 12/31/2999 12/31/2999J2405 00641607901 12/31/2999 12/31/2999J2405 00641608025 12/31/2999 12/31/2999J2405 00703722104 12/31/2999 12/31/2999J2405 00703722601 12/31/2999 12/31/2999J2405 00703722603 12/31/2999 12/31/2999J2405 00703723939 12/31/2999 11/29/2012J2405 00781301072 12/31/2999 12/31/2999J2405 00781301095 12/31/2999 12/31/2999J2405 10019090501 9/30/2013 11/9/2011J2405 10019090502 9/30/2013 11/9/2011J2405 10019090503 9/30/2013 11/9/2011J2405 10019090517 9/30/2013 11/9/2011J2405 10019090603 7/31/2013 2/17/2012J2405 10019090663 7/31/2013 2/17/2012J2405 23155016831 12/31/2999 12/31/2999J2405 23155019642 12/31/2999 12/31/2999J2405 23360001602 12/31/2999 5/1/2011J2405 23360001620 12/31/2999 5/1/2011J2405 25021077702 12/31/2999 12/31/2999J2405 25021078220 12/31/2999 12/31/2999J2405 36000001406 12/31/2999 12/4/2012J2405 51672409103 12/31/2999 12/31/2999J2405 55390012101 12/31/2999 12/31/2999J2405 55390012110 12/31/2999 5/2/2011J2405 55390030701 12/31/2999 5/2/2011J2405 60505038105 12/31/2999 12/31/2999J2405 60505074401 12/31/2999 12/31/2999J2405 60505074406 12/31/2999 12/31/2999J2405 61703024407 12/31/2999 6/30/2009J2405 61703024522 12/31/2999 6/30/2009J2405 62756018101 12/31/2999 12/31/2999J2405 62756018201 12/31/2999 12/31/2999J2405 63323037302 12/31/2999 12/31/2999J2405 63323037420 12/31/2999 12/31/2999J2405 64679072601 12/31/2999 12/31/2999J2405 64679072701 12/31/2999 12/31/2999J2405 65293037325 12/31/2999 12/31/2999

Page 89: *This document is a compilation of NDC:HCPCS combinations

J2405 65293037401 12/31/2999 12/31/2999J2405 66860008706 12/31/2999 12/31/2999J2405 66860008801 12/31/2999 12/31/2999J2405 76045010320 12/31/2999 12/31/2999J2410 63481062410 12/31/2999 12/31/2999J2425 66658011203 12/31/2999 12/31/2999J2425 66658011206 12/31/2999 12/31/2999J2426 50458056001 12/31/2999 12/31/2999J2426 50458056101 12/31/2999 12/31/2999J2426 50458056201 12/31/2999 12/31/2999J2426 50458056301 12/31/2999 12/31/2999J2426 50458056401 12/31/2999 12/31/2999J2430 00069010701 12/31/2999 12/31/2999J2430 00069010901 12/31/2999 12/31/2999J2430 00069018601 12/31/2999 12/31/2999J2430 00517074501 12/31/2999 12/31/2999J2430 00517074601 12/31/2999 12/31/2999J2430 00703407559 12/31/2999 12/31/2999J2430 00703408551 12/31/2999 12/31/2999J2430 00703408591 12/31/2999 11/6/2008J2430 15210040111 12/31/2999 6/17/2008J2430 15210040211 12/31/2999 5/2/2008J2430 23360002410 12/31/2999 5/1/2011J2430 25021080210 12/31/2999 12/31/2999J2430 25021080310 12/31/2999 12/31/2999J2430 55390012701 12/31/2999 12/31/2999J2430 55390012901 12/31/2999 12/31/2999J2430 55390015701 12/31/2999 4/18/2013J2430 55390015901 12/31/2999 4/18/2013J2430 55390020401 12/31/2999 5/2/2011J2430 55390060401 12/31/2999 5/2/2011J2430 61703032418 12/31/2999 12/31/2999J2430 61703032439 12/31/2999 2/29/2008J2430 61703032518 12/31/2999 12/31/2999J2430 61703032618 12/31/2999 12/31/2999J2430 61703035618 12/31/2999 12/31/2999J2430 63323073410 12/31/2999 12/31/2999J2430 63323073435 12/31/2999 9/1/2006J2430 63323073510 12/31/2999 12/31/2999J2440 00517400225 12/31/2999 12/31/2999J2440 00517401001 12/31/2999 12/31/2999J2460 00049076009 12/31/2999 12/31/1994J2460 00049077009 12/31/2999 12/31/1994J2469 62856079701 12/31/2999 12/31/2999J2469 62856079801 12/31/2999 4/1/2010J2501 00074165801 12/31/2999 12/31/2999J2501 00074165805 12/31/2999 12/31/2999

Page 90: *This document is a compilation of NDC:HCPCS combinations

J2501 00074463701 12/31/2999 12/31/2999J2503 68782000102 12/31/2999 12/31/2999J2504 57665000101 12/31/2999 12/31/2999J2505 54868522900 12/31/2999 12/31/2999J2505 55513019001 12/31/2999 12/31/2999J2507 54396080101 12/31/2999 12/31/2999J2510 54569139000 12/31/2999 6/21/1999J2510 60793013010 12/31/2999 12/31/2999J2510 60793013110 12/31/2999 12/31/2999J2515 67386050152 8/31/2014 6/6/2012J2515 67386050155 8/31/2014 6/6/2012J2515 76478050120 12/31/2999 12/31/2999J2515 76478050150 12/31/2999 12/31/2999J2540 00049052022 12/31/2999 12/31/2999J2540 00049052083 12/31/2999 12/31/2999J2540 00049053022 12/31/2999 12/31/2999J2540 00049053028 12/31/2999 12/31/2999J2540 00338102141 12/31/2999 12/31/2999J2540 00338102341 12/31/2999 12/31/2999J2540 00338102541 12/31/2999 12/31/2999J2540 00781613594 12/31/2999 12/31/2999J2540 00781613595 12/31/2999 12/31/2999J2540 00781613694 12/31/2999 12/31/2999J2540 54868448800 12/31/2999 6/30/2011J2540 63323032320 12/31/2999 12/31/2999J2540 63323032462 12/31/2999 12/31/2999J2543 00206240402 12/31/2999 12/31/2999J2543 00206240502 12/31/2999 12/31/2999J2543 00206240802 12/31/2999 12/31/2999J2543 00206240902 12/31/2999 12/31/2999J2543 00206241102 12/31/2999 12/31/2999J2543 00206241302 12/31/2999 12/31/2999J2543 00206241601 12/31/2999 12/31/2999J2543 00206250110 12/31/2999 12/31/2999J2543 00206350110 12/31/2999 12/31/2999J2543 00206450110 12/31/2999 12/31/2999J2543 00206885208 12/31/2999 12/31/2999J2543 00206885216 12/31/2999 12/31/2999J2543 00206885408 12/31/2999 12/31/2999J2543 00206885416 12/31/2999 12/31/2999J2543 00206885508 12/31/2999 12/31/2999J2543 00206885516 12/31/2999 12/31/2999J2543 00206885910 12/31/2999 12/31/2999J2543 00206886001 12/31/2999 12/31/2999J2543 00206886002 12/31/2999 12/31/2999J2543 00206886101 12/31/2999 12/31/2999J2543 00206886102 12/31/2999 12/31/2999

Page 91: *This document is a compilation of NDC:HCPCS combinations

J2543 00206886201 12/31/2999 12/31/2999J2543 00206886202 12/31/2999 12/31/2999J2543 00409337402 12/31/2999 12/31/2999J2543 00409337813 12/31/2999 12/31/2999J2543 00409337904 12/31/2999 12/31/2999J2543 00409338302 12/31/2999 12/31/2999J2543 00409338513 12/31/2999 12/31/2999J2543 00409339004 12/31/2999 12/31/2999J2543 00781311095 12/31/2999 12/31/2999J2543 00781311395 12/31/2999 12/31/2999J2543 00781311495 12/31/2999 12/31/2999J2543 25021016430 12/31/2999 12/31/2999J2543 25021016530 12/31/2999 12/31/2999J2543 25021016648 12/31/2999 12/31/2999J2543 44567080110 12/31/2999 12/31/2999J2543 44567080210 12/31/2999 12/31/2999J2543 44567080310 12/31/2999 12/31/2999J2543 44567080401 12/31/2999 12/31/2999J2543 44567088210 12/31/2999 12/31/2999J2543 60505068604 12/31/2999 12/31/2999J2543 60505068704 12/31/2999 12/31/2999J2543 60505068804 12/31/2999 12/31/2999J2543 60505077300 12/31/2999 12/31/2999J2543 63323030020 12/31/2999 9/24/2012J2543 63323030030 12/31/2999 12/31/2999J2543 63323030474 12/31/2999 12/31/2999J2543 63323030920 12/31/2999 12/31/2999J2543 63323032050 12/31/2999 12/31/2999J2545 54868252800 12/31/2999 6/30/2010J2545 63323087715 12/31/2999 12/31/2999J2550 00143986822 12/31/2999 6/10/2011J2550 00143986922 12/31/2999 6/10/2011J2550 00409231202 12/31/2999 12/31/2999J2550 00409231231 12/31/2999 12/31/2999J2550 00603158454 12/31/2999 12/31/2999J2550 00603158458 12/31/2999 12/31/2999J2550 00641092821 12/31/2999 12/31/2999J2550 00641092825 12/31/2999 12/31/2999J2550 00641094831 12/31/2999 12/31/2999J2550 00641094835 12/31/2999 12/31/2999J2550 00641094931 12/31/2999 12/31/2999J2550 00641094935 12/31/2999 12/31/2999J2550 00641095521 12/31/2999 12/31/2999J2550 00641095525 12/31/2999 12/31/2999J2550 00641149531 12/31/2999 12/31/2999J2550 00641149535 12/31/2999 12/31/2999J2550 00641149631 12/31/2999 12/31/2999

Page 92: *This document is a compilation of NDC:HCPCS combinations

J2550 00641149635 12/31/2999 12/31/2999J2550 00641608225 12/31/2999 12/31/2999J2550 00641608325 12/31/2999 12/31/2999J2550 00641608425 12/31/2999 12/31/2999J2550 00641608525 12/31/2999 12/31/2999J2550 00641609925 12/31/2999 2/1/2013J2550 00703219104 12/31/2999 12/31/2999J2550 00703220104 12/31/2999 12/31/2999J2550 10019009701 6/30/2013 11/9/2011J2550 10019009744 6/30/2013 11/9/2011J2550 39822550003 12/31/2999 12/31/2999J2550 39822550006 12/31/2999 12/31/2999J2550 50383080116 12/31/2999 12/31/2999J2550 54569388200 12/31/2999 1/31/2003J2550 54569560900 12/31/2999 12/31/2999J2550 54868026200 12/31/2999 3/31/2011J2550 54868059700 12/31/2999 5/31/2011J2550 54868208800 12/31/2999 6/30/2012J2550 54868402100 12/31/2999 12/31/2999J2550 60977000101 1/31/2014 2/17/2012J2550 60977000103 4/30/2013 10/17/2011J2550 60977000143 1/31/2014 2/17/2012J2550 60977000144 4/30/2013 10/17/2011J2550 60977000202 4/30/2014 2/17/2012J2550 60977000204 12/31/2999 2/17/2012J2550 60977000243 4/30/2014 2/17/2012J2550 60977000244 12/31/2999 2/17/2012J2550 66860009803 12/31/2999 12/31/2999J2550 66860009903 12/31/2999 12/31/2999J2550 67457015410 12/31/2999 11/28/2006J2560 00409234331 12/31/2999 4/1/2012J2560 00409234931 12/31/2999 12/31/2999J2560 00641047621 12/31/2999 12/31/2999J2560 00641047625 12/31/2999 12/31/2999J2560 00641047721 12/31/2999 12/31/2999J2560 00641047725 12/31/2999 12/31/2999J2562 00024586201 12/31/2999 12/31/2999J2562 58468014001 12/31/2999 12/31/2999J2590 00641611425 12/31/2999 12/31/2999J2590 00641611525 12/31/2999 12/31/2999J2590 10019029102 2/28/2013 5/4/2012J2590 10019029104 1/31/2013 5/4/2012J2590 10019029112 2/28/2013 5/4/2012J2590 10019029171 1/31/2013 5/4/2012J2590 42023011601 12/31/2999 12/31/2999J2590 42023011602 12/31/2999 12/31/2999J2590 42023011625 12/31/2999 12/31/2999

Page 93: *This document is a compilation of NDC:HCPCS combinations

J2590 42023013006 12/31/2999 12/31/2999J2590 42023014025 12/31/2999 12/31/2999J2590 42023014101 12/31/2999 12/31/2999J2590 42023014125 12/31/2999 12/31/2999J2590 43063002901 12/31/2999 12/31/2999J2590 54569421200 12/31/2999 1/31/2003J2590 61553073203 12/31/2999 12/31/2999J2590 61553074703 12/31/2999 12/31/2999J2590 63323001201 12/31/2999 12/31/2999J2590 63323001210 12/31/2999 12/31/2999J2590 63323001212 12/31/2999 12/31/2999J2590 63323001230 12/31/2999 12/31/2999J2590 66647614144 12/31/2999 12/31/2999J2597 00075245101 12/31/2999 12/31/2999J2597 00075245153 12/31/2999 12/31/2999J2597 00409226501 12/31/2999 12/31/2999J2597 00703505101 12/31/2999 12/31/2999J2597 00703505103 12/31/2999 12/31/2999J2597 00703505401 12/31/2999 12/31/2999J2597 54868388900 12/31/2999 6/30/2010J2597 55566503001 12/31/2999 12/31/2999J2597 55566504001 12/31/2999 12/31/2999J2597 62756052940 12/31/2999 12/31/2999J2675 00143972501 12/31/2999 12/31/2999J2675 00517075001 12/31/2999 12/31/2999J2675 00591312879 12/31/2999 12/31/2999J2675 63323026110 12/31/2999 12/31/2999J2680 55390046505 12/31/2999 5/2/2011J2680 60505066402 12/31/2999 10/1/2008J2680 63323027205 12/31/2999 12/31/2999J2690 00409190201 12/31/2999 12/31/2999J2690 00409190301 12/31/2999 12/31/2999J2690 54868313600 12/31/2999 6/30/2011J2690 63739045921 12/31/2999 2/24/2012J2700 00338101341 12/31/2999 12/31/2999J2700 00338101541 12/31/2999 12/31/2999J2700 00781309415 12/31/2999 12/31/2999J2700 00781309492 12/31/2999 12/31/2999J2700 00781309515 12/31/2999 12/31/2999J2700 00781309580 12/31/2999 12/31/2999J2700 00781309592 12/31/2999 12/31/2999J2700 00781309995 12/31/2999 12/31/2999J2700 00781310180 12/31/2999 12/31/2999J2700 00781310195 12/31/2999 12/31/2999J2700 00781310395 12/31/2999 12/31/2999J2700 00781910995 12/31/2999 12/31/2999J2700 00781911015 12/31/2999 12/31/2999

Page 94: *This document is a compilation of NDC:HCPCS combinations

J2700 00781911092 12/31/2999 12/31/2999J2700 00781911180 12/31/2999 12/31/2999J2700 00781911195 12/31/2999 12/31/2999J2700 00781911215 12/31/2999 12/31/2999J2700 00781911292 12/31/2999 12/31/2999J2700 00781911395 12/31/2999 12/31/2999J2700 25021014610 12/31/2999 12/31/2999J2700 25021016224 12/31/2999 12/31/2999J2700 25021016399 12/31/2999 12/31/2999J2710 00517003325 12/31/2999 12/31/2999J2710 00517003425 12/31/2999 12/31/2999J2710 10019027010 7/31/2013 9/7/2012J2710 10019027039 7/31/2013 9/7/2012J2710 10019027110 7/31/2013 10/10/2012J2710 10019027137 7/31/2013 10/10/2012J2710 63323038210 12/31/2999 12/31/2999J2710 63323038310 12/31/2999 12/31/2999J2720 63323022905 12/31/2999 12/31/2999J2720 63323022915 12/31/2999 12/31/2999J2720 63323022930 12/31/2999 12/31/2999J2720 63323022935 12/31/2999 12/31/2999J2724 00944417505 12/31/2999 12/31/2999J2724 00944417510 12/31/2999 12/31/2999J2730 60977014101 12/31/2999 12/31/2999J2730 60977014127 12/31/2999 12/31/2999J2760 55390011301 12/31/2999 12/31/2999J2765 00409217332 12/31/2999 12/31/2999J2765 00409341301 12/31/2999 5/25/2012J2765 00409341401 12/31/2999 12/31/2999J2765 00409341461 12/31/2999 12/31/2999J2765 00703450204 3/31/2013 2/3/2011J2765 54868416700 12/31/2999 6/30/2004J2765 58016481101 12/31/2999 12/31/2011J2765 60977045117 12/31/2999 11/29/2011J2765 60977045171 12/31/2999 11/29/2011J2765 60977045182 12/31/2999 11/29/2011J2765 76045010120 12/31/2999 12/31/2999J2770 61570026010 12/31/2999 12/31/2999J2778 50242008001 12/31/2999 12/31/2999J2778 50242008201 12/31/2999 12/31/2999J2780 00173036238 12/31/2999 12/31/2999J2780 00173036300 12/31/2999 12/31/2999J2780 00173036301 12/31/2999 12/31/2999J2780 00173044100 12/31/2999 6/14/2013J2780 24987036301 12/31/2999 12/31/2999J2780 24987036401 12/31/2999 12/31/2999J2780 54868577500 12/31/2999 6/30/2011

Page 95: *This document is a compilation of NDC:HCPCS combinations

J2780 55390061601 12/31/2999 12/31/2999J2780 55390061610 12/31/2999 12/31/2999J2780 55390061801 12/31/2999 12/31/2999J2780 68382042202 12/31/2999 12/31/2999J2780 68382042306 12/31/2999 12/31/2999J2783 00024515010 12/31/2999 12/31/2999J2783 00024515175 12/31/2999 12/31/2999J2785 00469650189 12/31/2999 12/31/2999J2788 00562780601 12/31/2999 12/31/2999J2788 00562780605 12/31/2999 12/31/2999J2788 00562780625 12/31/2999 12/31/2999J2788 00562780801 12/31/2999 10/7/2011J2788 00562780806 12/31/2999 10/7/2011J2788 00562780826 12/31/2999 10/7/2011J2788 13533063106 12/31/2999 12/31/2999J2790 00562780501 12/31/2999 12/31/2999J2790 00562780505 12/31/2999 12/31/2999J2790 00562780525 12/31/2999 12/31/2999J2790 00562780701 12/31/2999 10/7/2011J2790 00562780706 12/31/2999 10/7/2011J2790 00562780726 12/31/2999 10/7/2011J2790 00562780806 12/31/2999 10/7/2011J2790 13533063102 12/31/2999 12/31/2999J2791 44206030001 12/31/2999 12/31/2999J2791 44206030010 12/31/2999 12/31/2999J2792 00944295002 12/31/2999 11/1/2006J2792 00944295004 12/31/2999 11/1/2006J2792 00944295006 12/31/2999 11/1/2006J2792 00944296701 12/31/2999 10/1/2007J2792 13533063102 12/31/2999 12/31/2999J2792 13533063106 12/31/2999 12/31/2999J2792 53270300001 12/31/2999 12/31/2999J2792 53270310001 12/31/2999 12/31/2999J2792 53270330001 12/31/2999 12/31/2999J2792 53270350001 12/31/2999 12/31/2999J2793 61755000101 12/31/2999 12/31/2999J2794 50458030611 12/31/2999 12/31/2999J2794 50458030711 12/31/2999 12/31/2999J2794 50458030811 12/31/2999 12/31/2999J2794 50458030911 12/31/2999 12/31/2999J2795 00186085944 12/31/2999 4/16/2009J2795 00186085947 12/31/2999 2/1/2013J2795 00186085954 12/31/2999 7/14/2009J2795 00186085957 12/31/2999 2/1/2013J2795 00186085977 3/31/2013 6/18/2009J2795 00186085981 4/30/2013 5/18/2009J2795 00186085991 6/30/2013 7/24/2009

Page 96: *This document is a compilation of NDC:HCPCS combinations

J2795 00186086347 12/31/2999 2/1/2013J2795 00186086354 12/31/2999 4/30/2009J2795 00186086357 12/31/2999 2/1/2013J2795 00186086361 4/30/2013 7/20/2009J2795 00186086377 3/31/2013 7/29/2009J2795 00186086747 12/31/2999 2/16/2011J2795 00186086754 12/31/2999 9/16/2009J2795 00186086757 12/31/2999 2/1/2013J2795 00186086844 12/31/2999 8/5/2009J2795 00186086854 12/31/2999 5/18/2009J2795 00186086877 12/31/2999 8/27/2009J2795 45183090202 12/31/2999 12/31/2999J2795 45183090702 12/31/2999 12/31/2999J2795 61553020248 12/31/2999 12/31/2999J2795 61553022802 12/31/2999 12/31/2999J2795 61553022902 12/31/2999 12/31/2999J2795 63323028510 12/31/2999 12/31/2999J2795 63323028513 12/31/2999 12/31/2999J2795 63323028520 12/31/2999 12/31/2999J2795 63323028523 12/31/2999 12/31/2999J2795 63323028528 12/31/2999 12/31/2999J2795 63323028564 12/31/2999 12/31/2999J2795 63323028565 12/31/2999 12/31/2999J2795 63323028567 12/31/2999 12/31/2999J2795 63323028568 12/31/2999 12/31/2999J2795 63323028600 12/31/2999 12/31/2999J2795 63323028620 12/31/2999 12/31/2999J2795 63323028623 12/31/2999 12/31/2999J2795 63323028630 12/31/2999 12/31/2999J2795 63323028631 12/31/2999 12/31/2999J2795 63323028635 12/31/2999 12/31/2999J2795 63323028637 12/31/2999 12/31/2999J2795 63323028638 12/31/2999 12/31/2999J2795 63323028663 12/31/2999 12/31/2999J2795 63323028720 12/31/2999 12/31/2999J2795 63323028721 12/31/2999 12/31/2999J2795 63323028810 12/31/2999 12/31/2999J2795 63323028811 12/31/2999 12/31/2999J2795 63323028820 12/31/2999 12/31/2999J2795 63323028821 12/31/2999 12/31/2999J2795 63323028827 12/31/2999 12/31/2999J2796 55513022101 12/31/2999 12/31/2999J2796 55513022201 12/31/2999 12/31/2999J2800 00641610325 12/31/2999 12/31/2999J2800 60977015001 4/30/2014 7/25/2012J2800 60977015071 4/30/2014 7/25/2012J2805 00270055615 12/31/2999 12/31/2999

Page 97: *This document is a compilation of NDC:HCPCS combinations

J2810 00264955400 12/31/2999 8/31/2009J2810 00264955410 12/31/2999 12/31/2999J2810 00264955810 9/30/2013 12/31/2999J2810 00264955820 12/31/2999 4/1/1999J2810 00338044103 12/31/2999 12/31/2010J2810 00409766503 12/31/2999 7/1/2007J2810 00409766509 12/31/2999 4/1/2007J2810 00409766603 12/31/2999 6/12/2009J2810 00409766662 12/31/2999 12/31/2999J2810 00409766823 12/31/2999 12/31/2999J2810 00409767713 12/31/2999 12/31/2999J2810 00409770562 12/31/2999 12/31/2999J2820 00024584305 12/31/2999 12/31/2999J2820 50419005030 12/31/2999 10/30/2011J2820 58468018002 12/31/2999 12/31/2999J2820 58468018102 12/31/2999 12/31/2999J2850 67066000501 12/31/2999 12/31/2999J2916 00024279150 10/31/2014 4/13/2011J2916 00024279210 12/31/2999 12/31/2999J2916 00591014987 12/31/2999 12/31/2999J2916 00591250887 12/31/2999 12/31/2999J2916 52544014987 12/31/2999 12/31/2999J2920 00009003928 12/31/2999 12/31/2999J2920 00009003932 12/31/2999 12/31/2999J2920 00009004726 12/31/2999 12/31/2999J2920 00409321705 12/31/2999 12/31/2999J2920 00409568401 12/31/2999 9/1/2008J2920 00409568423 12/31/2999 12/31/2999J2920 54569393400 12/31/2999 1/2/2002J2920 54868076800 12/31/2999 1/1/2009J2920 55390020910 12/31/2999 5/2/2011J2920 63323025503 12/31/2999 12/31/2999J2930 00009000302 12/31/2999 12/31/2999J2930 00009001820 12/31/2999 12/31/2999J2930 00009003928 12/31/2999 12/31/2999J2930 00009003930 12/31/2999 12/31/2999J2930 00009003932 12/31/2999 12/31/2999J2930 00009004722 12/31/2999 12/31/2999J2930 00009004725 12/31/2999 12/31/2999J2930 00009004726 12/31/2999 12/31/2999J2930 00009069801 12/31/2999 12/31/2999J2930 00009075801 12/31/2999 12/31/2999J2930 00009079601 12/31/2999 12/31/2999J2930 00409321805 12/31/2999 12/31/2999J2930 00409568502 12/31/2999 8/1/2008J2930 00409568523 12/31/2999 12/31/2999J2930 21695058710 12/31/2999 12/31/2999

Page 98: *This document is a compilation of NDC:HCPCS combinations

J2930 54569155500 12/31/2999 1/2/2002J2930 54868362300 12/31/2999 6/30/2010J2930 54868363700 12/31/2999 6/30/2010J2930 54868363701 12/31/2999 6/30/2010J2930 55390021010 12/31/2999 5/2/2011J2930 55390021801 12/31/2999 9/22/2009J2930 55390021901 12/31/2999 9/22/2009J2930 55390025801 12/31/2999 5/2/2011J2930 55390025901 12/31/2999 5/2/2011J2930 63323025803 12/31/2999 12/31/2999J2930 63323026530 12/31/2999 12/31/2999J2941 00002733511 12/31/2999 12/31/2999J2941 00002733516 3/31/2013 2/14/2012J2941 00002814701 12/31/2999 12/31/2999J2941 00002814801 12/31/2999 12/31/2999J2941 00002814901 12/31/2999 12/31/2999J2941 00013262681 12/31/2999 12/31/2999J2941 00013264681 12/31/2999 12/31/2999J2941 00013264902 12/31/2999 12/31/2999J2941 00013265002 12/31/2999 12/31/2999J2941 00013265102 12/31/2999 12/31/2999J2941 00013265202 12/31/2999 12/31/2999J2941 00013265302 12/31/2999 12/31/2999J2941 00013265402 12/31/2999 12/31/2999J2941 00013265502 12/31/2999 12/31/2999J2941 00013265602 12/31/2999 12/31/2999J2941 00013265702 12/31/2999 12/31/2999J2941 00013265802 12/31/2999 12/31/2999J2941 00169770421 12/31/2999 12/31/2999J2941 00169770521 12/31/2999 12/31/2999J2941 00169770821 12/31/2999 12/31/2999J2941 00781300107 12/31/2999 12/31/2999J2941 00781300126 12/31/2999 12/31/2999J2941 00781400436 12/31/2999 12/31/2999J2941 44087000401 12/31/2999 12/31/2999J2941 44087000407 12/31/2999 12/31/2999J2941 44087000501 12/31/2999 12/31/2999J2941 44087000507 12/31/2999 12/31/2999J2941 44087000601 12/31/2999 12/31/2999J2941 44087000607 12/31/2999 12/31/2999J2941 44087100502 12/31/2999 12/31/2999J2941 44087108001 12/31/2999 12/31/2999J2941 44087108801 12/31/2999 12/31/2999J2941 44087338807 12/31/2999 12/31/2999J2941 50242001821 12/31/2999 12/31/2999J2941 50242002020 12/31/2999 12/31/2999J2941 50242002220 3/31/2013 4/1/2013

Page 99: *This document is a compilation of NDC:HCPCS combinations

J2941 50242004314 12/31/2999 12/31/2999J2941 50242007301 12/31/2999 12/31/2999J2941 50242007401 12/31/2999 12/31/2999J2941 50242007601 12/31/2999 12/31/2999J2941 54569493000 12/31/2999 10/1/2009J2941 54868560100 12/31/2999 6/30/2011J2941 54868576000 12/31/2999 12/31/2999J2941 57844071319 12/31/2999 12/31/2999J2941 58016477101 12/31/2999 11/29/2012J2993 24477004001 12/31/2999 12/31/2999J2993 24477004102 12/31/2999 12/31/2999J2997 50242004163 12/31/2999 12/31/2999J2997 50242004164 12/31/2999 12/31/2999J2997 50242004413 12/31/2999 12/31/2999J2997 50242008525 12/31/2999 12/31/2999J2997 50242008527 12/31/2999 12/31/2999J3000 39822070602 12/31/2999 12/31/2999J3010 00409127632 12/31/2999 12/31/2999J3010 00409909332 12/31/2999 12/31/2999J3010 00409909335 12/31/2999 12/31/2999J3010 00409909338 12/31/2999 12/31/2999J3010 00409909422 12/31/2999 12/31/2999J3010 00409909425 12/31/2999 12/31/2999J3010 00409909428 12/31/2999 12/31/2999J3010 00409909431 12/31/2999 12/31/2999J3010 00409909461 12/31/2999 12/31/2999J3010 00641602410 12/31/2999 12/31/2999J3010 00641602510 12/31/2999 12/31/2999J3010 00641602605 12/31/2999 12/31/2999J3010 00641602725 12/31/2999 12/31/2999J3010 00641602825 12/31/2999 12/31/2999J3010 00641602925 12/31/2999 12/31/2999J3010 00641603001 12/31/2999 12/31/2999J3010 10019003339 5/31/2015 11/13/2012J3010 10019003372 5/31/2015 11/13/2012J3010 10019003539 12/31/2999 10/10/2012J3010 10019003574 12/31/2999 10/10/2012J3010 10019003725 3/31/2014 10/10/2012J3010 10019003727 5/31/2014 7/25/2012J3010 10019003730 4/30/2014 7/25/2012J3010 10019003739 5/31/2014 7/25/2012J3010 10019003783 5/31/2014 7/25/2012J3010 10019003839 4/30/2015 10/10/2012J3010 10019003867 4/30/2015 10/10/2012J3010 17478003002 12/31/2999 12/31/2999J3010 17478003005 12/31/2999 12/31/2999J3010 17478003020 12/31/2999 12/31/2999

Page 100: *This document is a compilation of NDC:HCPCS combinations

J3010 17478003025 12/31/2999 12/31/2999J3010 17478003055 12/31/2999 12/31/2999J3010 45183011148 12/31/2999 12/31/2999J3010 45183011841 12/31/2999 12/31/2999J3010 54868315901 12/31/2999 6/30/1995J3010 54868373800 12/31/2999 6/30/2001J3010 54868373801 12/31/2999 6/30/2001J3010 61553010702 12/31/2999 12/31/2999J3010 61553010972 12/31/2999 12/31/2999J3010 61553011148 12/31/2999 12/31/2999J3010 61553011248 12/31/2999 12/31/2999J3010 61553011302 12/31/2999 12/31/2999J3010 61553011402 12/31/2999 12/31/2999J3010 61553011648 12/31/2999 12/31/2999J3010 61553011841 12/31/2999 12/31/2999J3010 61553027348 12/31/2999 12/31/2999J3010 61553053069 12/31/2999 12/31/2999J3010 61553060248 12/31/2999 12/31/2999J3010 61553060348 12/31/2999 12/31/2999J3010 61553060402 12/31/2999 12/31/2999J3010 61553060548 12/31/2999 12/31/2999J3010 61553060641 12/31/2999 12/31/2999J3010 61553073068 12/31/2999 12/31/2999J3010 61553079168 12/31/2999 12/31/2999J3010 61553079268 12/31/2999 12/31/2999J3010 61553079368 12/31/2999 12/31/2999J3010 61553079468 12/31/2999 12/31/2999J3010 61553079568 12/31/2999 12/31/2999J3030 00173044902 12/31/2999 12/31/2999J3030 00173047800 12/31/2999 12/31/2999J3030 00173047900 12/31/2999 12/31/2999J3030 00173073900 12/31/2999 12/31/2999J3030 00173073902 12/31/2999 12/31/2999J3030 00703735101 12/31/2999 12/31/2999J3030 00703735102 12/31/2999 12/31/2999J3030 00781316907 12/31/2999 12/31/2999J3030 00781317007 12/31/2999 12/31/2999J3030 00781317207 12/31/2999 12/31/2999J3030 00781317307 12/31/2999 12/31/2999J3030 00781317414 12/31/2999 12/31/2999J3030 00781317471 12/31/2999 12/31/2999J3030 25021070360 12/31/2999 12/31/2999J3030 42023012105 12/31/2999 12/31/2999J3030 43376010606 12/31/2999 12/31/2999J3030 47335027641 12/31/2999 12/31/2999J3030 49884048252 10/31/2013 4/9/2012J3030 49884048299 10/31/2013 4/9/2012

Page 101: *This document is a compilation of NDC:HCPCS combinations

J3030 49884048352 12/31/2999 4/2/2013J3030 49884048399 12/31/2999 4/2/2013J3030 54569370400 12/31/2999 8/1/2010J3030 54868265200 12/31/2999 6/30/2011J3030 54868265201 12/31/2999 6/30/2011J3030 54868318000 12/31/2999 6/30/2011J3030 54868318100 12/31/2999 3/31/2011J3030 55390031510 1/31/2012 1/24/2013J3030 55390032502 1/31/2012 1/24/2013J3030 63323027301 12/31/2999 12/31/2999J3030 64679072801 12/31/2999 12/31/2999J3030 66860002206 12/31/2999 12/31/2999J3030 68115077002 12/31/2999 4/1/2009J3060 00069010601 12/31/2999 12/31/2999J3070 00409194101 12/31/2999 12/31/2999J3070 21695024101 12/31/2999 12/31/2999J3070 54868253000 12/31/2999 6/30/2001J3095 00469352530 12/31/2999 12/31/2999J3095 00469357550 12/31/2999 12/31/2999J3095 52118000101 12/31/2999 12/31/2999J3101 50242012001 12/31/2999 12/31/2999J3105 00143974610 12/31/2999 12/31/2999J3105 17478093301 12/31/2999 8/8/2012J3105 55390010110 12/31/2999 12/31/2999J3105 55390019310 6/30/2012 4/18/2013J3105 63323066501 12/31/2999 12/31/2999J3110 00002840001 12/31/2999 12/31/2999J3120 00591322126 12/31/2999 12/31/2999J3120 54396032840 12/31/2999 10/31/2008J3120 54868501600 12/31/2999 6/30/2011J3130 00143975001 12/31/2999 12/31/2999J3130 00591322126 12/31/2999 12/31/2999J3130 54396032840 12/31/2999 10/31/2008J3130 54868501600 12/31/2999 6/30/2011J3130 67979050140 12/31/2999 12/31/2999J3230 00641139731 12/31/2999 12/31/2999J3230 00641139735 12/31/2999 12/31/2999J3230 00641139831 12/31/2999 12/31/2999J3230 00641139835 12/31/2999 12/31/2999J3240 58468184904 12/31/2999 12/31/2999J3243 00008499001 12/31/2999 12/31/2999J3243 00008499002 12/31/2999 12/31/2999J3243 00008499019 12/31/2999 12/31/2999J3243 00008499020 12/31/2999 12/31/2999J3246 25208000201 12/31/2999 12/31/2999J3246 25208000202 12/31/2999 12/31/2999J3250 21695085320 12/31/2999 12/31/2999

Page 102: *This document is a compilation of NDC:HCPCS combinations

J3250 42023011801 12/31/2999 12/31/2999J3250 42023011925 12/31/2999 12/31/2999J3250 42023014201 12/31/2999 12/31/2999J3250 42023014325 12/31/2999 12/31/2999J3250 54569179601 12/31/2999 1/31/2003J3260 00069008802 12/31/2999 12/31/2999J3260 00069009103 12/31/2999 12/31/2999J3260 00069030102 12/31/2999 12/31/2999J3260 00069030202 12/31/2999 12/31/2999J3260 00074325403 12/31/2999 5/2/2011J3260 00409346913 12/31/2999 12/31/2999J3260 00409347023 12/31/2999 12/31/2999J3260 00409357701 12/31/2999 12/31/2999J3260 00409357801 12/31/2999 12/31/2999J3260 00409359002 12/31/2999 12/31/2999J3260 00703940204 12/31/2999 12/31/2999J3260 00703941601 12/31/2999 12/31/2999J3260 39822041201 12/31/2999 12/31/2999J3260 39822041206 12/31/2999 12/31/2999J3260 54868410600 12/31/2999 12/31/2999J3260 63323030351 12/31/2999 12/31/2999J3260 63323030355 12/31/2999 12/31/2999J3260 63323030502 12/31/2999 12/31/2999J3260 63323030602 12/31/2999 12/31/2999J3260 63323030630 12/31/2999 12/31/2999J3260 63323030655 12/31/2999 12/31/2999J3260 63323030656 12/31/2999 12/31/2999J3260 63323030751 12/31/2999 12/31/2999J3262 50242013501 12/31/2999 12/31/2999J3262 50242013601 12/31/2999 12/31/2999J3262 50242013701 12/31/2999 12/31/2999J3285 66302010101 12/31/2999 12/31/2999J3285 66302010201 12/31/2999 12/31/2999J3285 66302010501 12/31/2999 12/31/2999J3285 66302011001 12/31/2999 12/31/2999J3300 00065054301 12/31/2999 12/31/2999J3301 00003029305 12/31/2999 12/31/2999J3301 00003029320 12/31/2999 12/31/2999J3301 00003029328 12/31/2999 12/31/2999J3301 00003049420 12/31/2999 12/31/2999J3301 00065054301 12/31/2999 12/31/2999J3301 00781324375 12/31/2999 10/1/2009J3301 00781324572 12/31/2999 10/1/2009J3301 21695036001 12/31/2999 12/31/2999J3301 35356008201 12/31/2999 12/31/2999J3301 49999041505 12/31/2999 12/31/2999J3301 54569139800 12/31/2999 1/31/2003

Page 103: *This document is a compilation of NDC:HCPCS combinations

J3301 54569182701 12/31/2999 1/31/2003J3301 54569546500 12/31/2999 1/31/2003J3301 54868023400 12/31/2999 12/31/2999J3301 54868023500 12/31/2999 6/30/2012J3301 54868023501 12/31/2999 6/30/2012J3301 54868023502 12/31/2999 6/30/2012J3301 58016979901 12/31/2999 11/29/2012J3303 00781308475 12/31/2999 12/31/2999J3303 00781308571 12/31/2999 12/31/2999J3303 00781308575 12/31/2999 12/31/2999J3303 54868334400 12/31/2999 6/30/2011J3303 58016485501 12/31/2999 11/29/2012J3315 52544009276 12/31/2999 12/31/2999J3315 52544015302 12/31/2999 12/31/2999J3315 52544015402 12/31/2999 12/31/2999J3315 52544018876 12/31/2999 12/31/2999J3315 52544018976 12/31/2999 12/31/2999J3355 55566850502 12/31/2999 12/31/2999J3355 55566850506 12/31/2999 12/31/2999J3357 57894006002 12/31/2999 10/14/2010J3357 57894006003 12/31/2999 12/31/2999J3357 57894006103 12/31/2999 12/31/2999J3360 00074321301 12/31/2999 5/2/2011J3360 00409127332 12/31/2999 12/31/2999J3360 00409321302 12/31/2999 12/31/2999J3360 00409321312 12/31/2999 12/31/2999J3360 11704060001 12/31/2999 12/31/2999J3360 21695088910 12/31/2999 12/31/2999J3360 35356037102 12/31/2999 12/31/2999J3360 35356037110 12/31/2999 12/31/2999J3360 54569604400 12/31/2999 12/31/2999J3360 54868061700 12/31/2999 6/30/2012J3360 54868061701 12/31/2999 6/30/2012J3360 54868061702 12/31/2999 6/30/2012J3360 54868232001 12/31/2999 6/30/1996J3360 54868232002 12/31/2999 6/30/1996J3360 54868458600 12/31/2999 6/30/2011J3360 55045213303 12/31/2999 10/7/2009J3360 66758002002 12/31/2999 3/9/2007J3365 24430100301 12/31/2999 10/7/2009J3370 00069258710 12/31/2999 12/31/2999J3370 00069258910 12/31/2999 12/31/2999J3370 00069259001 12/31/2999 12/31/2999J3370 00069259999 12/31/2999 12/31/2999J3370 00069260101 12/31/2999 12/31/2999J3370 00338355148 12/31/2999 12/31/2999J3370 00338355248 12/31/2999 12/31/2999

Page 104: *This document is a compilation of NDC:HCPCS combinations

J3370 00338358048 12/31/2999 12/31/2999J3370 00409433201 12/31/2999 12/31/2999J3370 00409433249 12/31/2999 12/31/2999J3370 00409650901 12/31/2999 12/31/2999J3370 00409650949 12/31/2999 12/31/2999J3370 00409651001 12/31/2999 12/31/2999J3370 00409651049 12/31/2999 12/31/2999J3370 00409653101 12/31/2999 12/31/2999J3370 00409653102 12/31/2999 12/31/2999J3370 00409653301 12/31/2999 12/31/2999J3370 00409653349 12/31/2999 12/31/2999J3370 00409653361 12/31/2999 12/31/2999J3370 00409653401 12/31/2999 12/31/2999J3370 00409653449 12/31/2999 12/31/2999J3370 00409653501 12/31/2999 12/31/2999J3370 00409653549 12/31/2999 12/31/2999J3370 00641277941 12/31/2999 6/21/1995J3370 00781318770 12/31/2999 12/31/2999J3370 00781318795 12/31/2999 12/31/2999J3370 00781318880 12/31/2999 12/31/2999J3370 00781318895 12/31/2013 12/31/2999J3370 10139050112 5/31/2012 8/24/2010J3370 10139050120 5/31/2012 9/23/2011J3370 21695042401 12/31/2999 5/1/2011J3370 23360015140 2/28/2013 5/1/2011J3370 23360015250 2/28/2013 5/1/2011J3370 23360015365 3/31/2013 5/1/2011J3370 25021015799 12/31/2999 12/31/2999J3370 63323022110 12/31/2999 12/31/2999J3370 63323028420 12/31/2999 12/31/2999J3370 63323029561 12/31/2999 12/31/2999J3370 63323031461 12/31/2999 12/31/2999J3370 67457022220 12/31/2999 12/31/2999J3370 67457022510 12/31/2999 12/31/2999J3370 67457034001 12/31/2999 12/31/2999J3385 54092070104 12/31/2999 12/31/2999J3396 00187560015 12/31/2999 12/31/2999J3396 50236000115 12/31/2999 12/31/2999J3410 00517420125 12/31/2999 12/31/2999J3410 00517560125 12/31/2999 12/31/2999J3410 00517560225 12/31/2999 12/31/2999J3410 00517561025 12/31/2999 12/31/2999J3410 54868023100 12/31/2999 5/31/2011J3410 58016929901 12/31/2999 11/29/2012J3410 63323002101 12/31/2999 8/14/2009J3410 63323005102 12/31/2999 8/14/2009J3411 54868248900 12/31/2999 6/30/2012

Page 105: *This document is a compilation of NDC:HCPCS combinations

J3411 54868248901 12/31/2999 6/30/2012J3411 63323001302 12/31/2999 12/31/2999J3411 67457019602 12/31/2999 12/31/2999J3415 54569475200 12/31/2999 6/1/2003J3415 63323018001 12/31/2999 12/31/2999J3420 00517003125 12/31/2999 12/31/2999J3420 00517003225 12/31/2999 12/31/2999J3420 00517013005 12/31/2999 12/31/2999J3420 30727031480 12/31/2999 5/11/2009J3420 49326040610 12/31/2999 12/31/2008J3420 54569553300 12/31/2999 1/28/2013J3420 54868076200 12/31/2999 12/31/2999J3420 54868076201 12/31/2999 12/31/2999J3420 63323004401 12/31/2999 12/31/2999J3430 00409915701 12/31/2999 12/31/2999J3430 00409915801 12/31/2999 12/31/2999J3430 00548114000 9/30/2013 10/1/2012J3430 00548124000 1/31/2014 10/1/2012J3430 54868443400 12/31/2999 12/31/2999J3465 00049319001 12/31/2999 12/31/2999J3465 00049319028 12/31/2999 12/31/2999J3465 00049319038 12/31/2999 12/31/2999J3465 00049419001 12/31/2999 12/31/2999J3465 00781341694 12/31/2999 12/31/2999J3470 00548909000 12/31/2999 1/1/2010J3470 00548909010 12/31/2999 1/1/2010J3470 67425000210 12/31/2999 12/31/2999J3471 67425000210 12/31/2999 12/31/2999J3472 67425000210 12/31/2999 12/31/2999J3473 18657010204 12/31/2999 12/31/2999J3475 00074491315 12/31/2999 5/2/2011J3475 00074491418 12/31/2999 5/2/2011J3475 00409175410 12/31/2999 12/31/2999J3475 00409216802 12/31/2999 12/31/2999J3475 00409672723 12/31/2999 12/31/2999J3475 00409672903 12/31/2999 12/31/2999J3475 00409672909 12/31/2999 12/31/2999J3475 00409672923 12/31/2999 12/31/2999J3475 00409672924 12/31/2999 12/31/2999J3475 00409673013 12/31/2999 12/31/2999J3475 00517260225 12/31/2999 12/31/2999J3475 00517261025 12/31/2999 12/31/2999J3475 00517265025 12/31/2999 12/31/2999J3475 54868594900 12/31/2999 6/30/2011J3475 61553041141 12/31/2999 12/31/2999J3475 61553042003 12/31/2999 12/31/2999J3475 61553042104 12/31/2999 12/31/2999

Page 106: *This document is a compilation of NDC:HCPCS combinations

J3475 61553042302 12/31/2999 12/31/2999J3475 61553042648 12/31/2999 12/31/2999J3475 63323006402 12/31/2999 12/31/2999J3475 63323006410 12/31/2999 12/31/2999J3475 63323006420 12/31/2999 12/31/2999J3475 63323006450 12/31/2999 12/31/2999J3480 00074149901 12/31/2999 5/2/2011J3480 00074493101 12/31/2999 5/2/2011J3480 00074493201 12/31/2999 5/2/2011J3480 00264194020 12/31/2999 12/31/2999J3480 00264762500 12/31/2999 12/31/2999J3480 00264786500 12/31/2999 12/31/2999J3480 00338031802 12/31/2999 1/31/2011J3480 00338068304 12/31/2999 12/31/2999J3480 00338069104 12/31/2999 12/31/2999J3480 00338069504 12/31/2999 12/31/2999J3480 00338070341 12/31/2999 12/31/2999J3480 00338070348 12/31/2999 12/31/2999J3480 00338070434 12/31/2999 12/31/2999J3480 00338070541 12/31/2999 12/31/2999J3480 00338070548 12/31/2999 12/31/2999J3480 00338070948 12/31/2999 12/31/2999J3480 00409151302 12/31/2999 12/31/2999J3480 00409390703 12/31/2999 10/1/2006J3480 00409663501 12/31/2999 12/31/2999J3480 00409663601 12/31/2999 12/31/2999J3480 00409665106 12/31/2999 12/31/2999J3480 00409665305 12/31/2999 12/31/2999J3480 00409707426 12/31/2999 12/31/2999J3480 00409707514 12/31/2999 12/31/2999J3480 00409707526 12/31/2999 12/31/2999J3480 00409707626 12/31/2999 12/31/2999J3480 00409707714 12/31/2999 12/31/2999J3480 00409707726 12/31/2999 12/31/2999J3480 00409711509 12/31/2999 12/31/2999J3480 00409711609 12/31/2999 12/31/2999J3480 00409790509 12/31/2999 12/31/2999J3480 00409925739 12/31/2999 12/31/2999J3480 54868076701 12/31/2999 6/30/2012J3480 63323096505 12/31/2999 12/31/2999J3480 63323096510 12/31/2999 12/31/2999J3480 63323096515 12/31/2999 6/4/2012J3480 63323096520 12/31/2999 12/31/2999J3480 63323096730 12/31/2999 12/31/2999J3485 00173010793 5/31/2013 2/11/2011J3485 49702021305 12/31/2999 12/31/2999J3486 00049392083 12/31/2999 12/31/2999

Page 107: *This document is a compilation of NDC:HCPCS combinations

J3487 00078038725 12/31/2999 12/31/2999J3487 00078059061 12/31/2999 12/31/2999J3487 25021080166 12/31/2999 12/31/2999J3488 00078043561 12/31/2999 12/31/2999J3488 23155018631 12/31/2999 12/31/2999J3488 35356035101 12/31/2999 1/1/2010J3489 00078038725 12/31/2999 12/31/2999J3489 00078043561 12/31/2999 12/31/2999J3489 00078059061 12/31/2999 12/31/2999J3489 00143964201 12/31/2999 12/31/2999J3489 23155017031 12/31/2999 12/31/2999J3489 23155018631 12/31/2999 12/31/2999J3489 25021080166 12/31/2999 12/31/2999J3489 25021082682 12/31/2999 12/31/2999J3489 25021083082 12/31/2999 12/31/2999J3489 42023015101 12/31/2999 12/31/2999J3489 42023016301 12/31/2999 12/31/2999J3489 43598033011 12/31/2999 12/31/2999J3489 43598033111 12/31/2999 12/31/2999J3489 47335003540 12/31/2999 12/31/2999J3489 47335096241 12/31/2999 12/31/2999J3489 53150087101 12/31/2999 12/31/2999J3489 55111068507 12/31/2999 12/31/2999J3489 55111068852 12/31/2999 12/31/2999J3490 00002759701 12/31/2999 12/31/2999J3490 00002763511 12/31/2999 12/31/2999J3490 00002763611 12/31/2999 12/31/2999J3490 00002763711 12/31/2999 12/31/2999J3490 00003037113 12/31/2999 12/31/2999J3490 00003218710 12/31/2999 12/31/2999J3490 00003223011 12/31/2999 12/31/2999J3490 00003224011 12/31/2999 12/31/2999J3490 00003224101 12/31/2999 4/1/1999J3490 00003256016 12/31/2999 12/31/2999J3490 00003257016 12/31/2999 12/31/2999J3490 00004003822 12/31/2999 12/31/2999J3490 00004035009 12/31/2999 12/31/2999J3490 00004035239 7/13/2014 12/31/2999J3490 00004038039 6/30/2013 7/2/2013J3490 00004691106 1/31/2013 1/31/2013J3490 00006394132 12/31/2999 12/31/2999J3490 00007440106 12/31/2999 12/31/2999J3490 00008092351 12/31/2999 12/31/2999J3490 00008092355 12/31/2999 12/31/2999J3490 00008117901 12/31/2999 12/31/2999J3490 00008117905 12/31/2999 12/31/2999J3490 00009023301 12/31/2999 12/31/2999

Page 108: *This document is a compilation of NDC:HCPCS combinations

J3490 00009023344 4/1/2013 1/1/2011J3490 00009043624 12/31/2999 2/26/2013J3490 00009072809 12/31/2999 12/31/2999J3490 00009077526 12/31/2999 12/31/2999J3490 00009087026 12/31/2999 12/31/2999J3490 00009090211 12/31/2999 12/31/2999J3490 00009090218 12/31/2999 12/31/2999J3490 00009312403 12/31/2999 12/31/2999J3490 00009337502 12/31/2999 12/31/2999J3490 00009338102 12/31/2999 12/31/2999J3490 00009338201 12/31/2999 12/31/2999J3490 00009338202 12/31/2999 12/31/2999J3490 00009344703 12/31/2999 12/31/2999J3490 00015191012 12/31/2999 12/31/2999J3490 00015191113 12/31/2999 12/31/2999J3490 00023334807 12/31/2999 12/31/2999J3490 00024582411 12/31/2999 12/31/2999J3490 00024584001 12/31/2999 12/31/2999J3490 00024584101 12/31/2999 12/31/2999J3490 00029657126 12/31/2999 12/31/2999J3490 00029657131 12/31/2999 12/31/2999J3490 00029657921 12/31/2999 12/31/2999J3490 00052027201 12/31/2999 12/31/2999J3490 00052030151 12/31/2999 12/31/2999J3490 00065054301 12/31/2999 12/31/2999J3490 00068059701 12/31/2999 12/31/2999J3490 00069000601 12/31/2999 12/31/2999J3490 00069000603 12/31/2999 12/31/2999J3490 00069009303 12/31/2999 12/31/2999J3490 00069009402 12/31/2999 12/31/2999J3490 00069010404 12/31/2999 12/31/2999J3490 00069010503 12/31/2999 12/31/2999J3490 00069010601 12/31/2999 12/31/2999J3490 00069010805 12/31/2999 12/31/2999J3490 00069011201 12/31/2999 12/31/2999J3490 00069012102 12/31/2999 12/31/2999J3490 00069012502 12/31/2999 12/31/2999J3490 00069012602 12/31/2999 12/31/2999J3490 00069014101 12/31/2999 1/30/2013J3490 00074114315 12/31/2999 7/19/2011J3490 00074156410 12/31/2999 12/31/2999J3490 00074229111 12/31/2999 5/2/2011J3490 00074400001 12/31/2999 7/19/2011J3490 00074445651 12/31/2999 12/31/2999J3490 00078040001 12/31/2999 12/31/2999J3490 00078041420 12/31/2999 12/31/2999J3490 00078041520 12/31/2999 12/31/2999

Page 109: *This document is a compilation of NDC:HCPCS combinations

J3490 00078041720 12/31/2999 12/31/2999J3490 00078058261 12/31/2999 12/31/2999J3490 00085127901 12/31/2999 12/31/2999J3490 00085129101 12/31/2999 12/31/2999J3490 00085129701 12/31/2999 12/31/2999J3490 00085129702 12/31/2999 12/31/2999J3490 00085130401 12/31/2999 12/31/2999J3490 00085131601 12/31/2999 12/31/2999J3490 00085131602 12/31/2999 12/31/2999J3490 00085132301 12/31/2999 12/31/2999J3490 00085132302 12/31/2999 12/31/2999J3490 00085136801 12/31/2999 12/31/2999J3490 00085137001 12/31/2999 12/31/2999J3490 00085137002 12/31/2999 12/31/2999J3490 00121059530 12/31/2999 12/31/2999J3490 00143966010 12/31/2999 12/31/2999J3490 00143967910 12/31/2999 12/31/2999J3490 00143968025 12/31/2999 12/31/2999J3490 00143968125 12/31/2999 12/31/2999J3490 00143968225 12/31/2999 12/31/2999J3490 00143968310 12/31/2999 12/31/2999J3490 00143968410 12/31/2999 12/31/2999J3490 00143977226 12/31/2999 5/13/2011J3490 00143978310 12/31/2999 12/31/2999J3490 00143978410 12/31/2999 12/31/2999J3490 00143978610 12/31/2999 12/31/2999J3490 00143978710 12/31/2999 12/31/2999J3490 00143987310 12/31/2999 12/31/2999J3490 00186015501 5/31/2013 7/13/2010J3490 00186024444 12/31/2999 2/1/2013J3490 00186103001 4/30/2013 8/4/2009J3490 00186103101 4/30/2013 11/5/2009J3490 00186103301 5/31/2013 9/16/2009J3490 00186103312 4/30/2013 1/4/2010J3490 00186103501 5/31/2013 9/1/2009J3490 00186103712 12/31/2999 8/4/2009J3490 00186602001 12/31/2999 12/31/2999J3490 00186604001 12/31/2999 12/31/2999J3490 00264180031 12/31/2999 12/31/2999J3490 00264553532 12/31/2999 12/31/2999J3490 00264762500 12/31/2999 12/31/2999J3490 00264780510 12/31/2999 12/31/2999J3490 00264780610 12/31/2999 12/31/2999J3490 00270055615 12/31/2999 12/31/2999J3490 00310030065 12/31/2999 3/17/2008J3490 00338005403 12/31/2999 12/31/2999J3490 00338005603 12/31/2999 12/31/2999

Page 110: *This document is a compilation of NDC:HCPCS combinations

J3490 00338101741 12/31/2999 12/31/2999J3490 00338101948 12/31/2999 12/31/2999J3490 00338104702 12/31/2999 12/31/2999J3490 00338104902 12/31/2999 12/31/2999J3490 00338105102 12/31/2999 12/31/2999J3490 00338105548 12/31/2999 12/31/2999J3490 00338519741 12/31/2999 12/31/2999J3490 00338519841 12/31/2999 10/18/2008J3490 00407408601 12/31/2999 12/31/2012J3490 00409114402 12/31/2999 12/31/2999J3490 00409115801 12/31/2999 12/31/2999J3490 00409115901 12/31/2999 12/31/2999J3490 00409115902 12/31/2999 12/31/2999J3490 00409116001 12/31/2999 12/31/2999J3490 00409116101 12/31/2999 12/31/2999J3490 00409116201 12/31/2999 12/31/2999J3490 00409116202 12/31/2999 12/31/2999J3490 00409116301 12/31/2999 12/31/2999J3490 00409116401 12/31/2999 12/31/2999J3490 00409116501 12/31/2999 12/31/2999J3490 00409116502 12/31/2999 12/31/2999J3490 00409117101 12/31/2999 12/31/2999J3490 00409117102 12/31/2999 12/31/2999J3490 00409132305 12/31/2999 12/31/2999J3490 00409141204 12/31/2999 12/31/2999J3490 00409141210 12/31/2999 12/31/2999J3490 00409141249 12/31/2999 12/31/2999J3490 00409141250 12/31/2999 12/31/2999J3490 00409148202 12/31/2999 12/31/2999J3490 00409148302 12/31/2999 12/31/2999J3490 00409148303 12/31/2999 12/31/2999J3490 00409148402 12/31/2999 12/31/2999J3490 00409148403 12/31/2999 12/31/2999J3490 00409155910 12/31/2999 12/31/2999J3490 00409155930 12/31/2999 12/31/2999J3490 00409156010 12/31/2999 12/31/2999J3490 00409156029 12/31/2999 12/31/2999J3490 00409158210 12/31/2999 12/31/2999J3490 00409158229 12/31/2999 12/31/2999J3490 00409158603 12/31/2999 12/31/2999J3490 00409158750 12/31/2999 12/31/2999J3490 00409161050 12/31/2999 12/31/2999J3490 00409163110 12/31/2999 12/31/2999J3490 00409163201 12/31/2999 12/31/2999J3490 00409163249 12/31/2999 12/31/2999J3490 00409163401 12/31/2999 12/31/2999J3490 00409176102 12/31/2999 12/31/2999

Page 111: *This document is a compilation of NDC:HCPCS combinations

J3490 00409177805 12/31/2999 12/31/2999J3490 00409177835 12/31/2999 12/31/2999J3490 00409195501 12/31/2999 12/31/2999J3490 00409195701 12/31/2999 12/31/2999J3490 00409205105 12/31/2999 12/31/2999J3490 00409205310 12/31/2999 12/31/2999J3490 00409206605 12/31/2999 12/31/2999J3490 00409212201 12/31/2999 12/31/2999J3490 00409212202 12/31/2999 12/31/2999J3490 00409212213 12/31/2999 12/31/2999J3490 00409212288 12/31/2999 12/31/2999J3490 00409226602 12/31/2999 12/31/2999J3490 00409226605 12/31/2999 12/31/2999J3490 00409226649 12/31/2999 12/31/2999J3490 00409226651 12/31/2999 12/31/2999J3490 00409226720 12/31/2999 12/31/2999J3490 00409226754 12/31/2999 12/31/2999J3490 00409228505 12/31/2999 12/31/2999J3490 00409233934 12/31/2999 12/31/2999J3490 00409263405 12/31/2999 12/31/2999J3490 00409329451 12/31/2999 12/31/2999J3490 00409329905 12/31/2999 12/31/2999J3490 00409329906 12/31/2999 12/31/2999J3490 00409338031 12/31/2999 12/31/2999J3490 00409338032 12/31/2999 12/31/2999J3490 00409338035 12/31/2999 12/31/2999J3490 00409338049 12/31/2999 12/31/2999J3490 00409338050 12/31/2999 12/31/2999J3490 00409338051 12/31/2999 12/31/2999J3490 00409338221 12/31/2999 12/31/2999J3490 00409338222 12/31/2999 12/31/2999J3490 00409338225 12/31/2999 12/31/2999J3490 00409361301 12/31/2999 12/31/2999J3490 00409401101 12/31/2999 12/31/2999J3490 00409405001 12/31/2999 12/31/2999J3490 00409405101 12/31/2999 12/31/2999J3490 00409405201 12/31/2999 12/31/2999J3490 00409405303 12/31/2999 12/31/2999J3490 00409405403 12/31/2999 12/31/2999J3490 00409405503 12/31/2999 12/31/2999J3490 00409405601 12/31/2999 12/31/2999J3490 00409419701 12/31/2999 12/31/2999J3490 00409427201 12/31/2999 12/31/2999J3490 00409427301 12/31/2999 12/31/2999J3490 00409427501 6/1/2013 6/1/2013J3490 00409427601 12/31/2999 12/31/2999J3490 00409427602 12/31/2999 12/31/2999

Page 112: *This document is a compilation of NDC:HCPCS combinations

J3490 00409427701 12/31/2999 12/31/2999J3490 00409427702 12/31/2999 12/31/2999J3490 00409427801 12/31/2999 12/31/2999J3490 00409428201 12/31/2999 12/31/2999J3490 00409428202 12/31/2999 12/31/2999J3490 00409428301 12/31/2999 12/31/2999J3490 00409434673 12/31/2999 12/31/2999J3490 00409435003 12/31/2999 12/31/2999J3490 00409469924 12/31/2999 12/31/2999J3490 00409469930 12/31/2999 12/31/2999J3490 00409469933 12/31/2999 12/31/2999J3490 00409469962 12/31/2999 12/31/2999J3490 00409477601 12/31/2999 12/31/2999J3490 00409490034 12/31/2999 12/31/2999J3490 00409490334 12/31/2999 12/31/2999J3490 00409491634 12/31/2999 12/31/2999J3490 00409492834 12/31/2999 12/31/2999J3490 00409553434 12/31/2999 12/31/2999J3490 00409562201 12/31/2999 12/31/2999J3490 00409575701 12/31/2999 12/31/2999J3490 00409660902 12/31/2999 12/31/2999J3490 00409662502 12/31/2999 12/31/2999J3490 00409663734 12/31/2999 12/31/2999J3490 00409669501 12/31/2999 12/31/2999J3490 00409669502 12/31/2999 12/31/2999J3490 00409711609 12/31/2999 12/31/2999J3490 00409729501 12/31/2999 5/1/2012J3490 00409729973 12/31/2999 12/31/2999J3490 00409744401 12/31/2999 12/31/2999J3490 00409744501 12/31/2999 12/31/2999J3490 00409781124 12/31/2999 12/31/2999J3490 00409781137 12/31/2999 12/31/2999J3490 00409790509 12/31/2999 12/31/2999J3490 00409806029 12/31/2999 12/31/2999J3490 00409806101 12/31/2999 12/31/2999J3490 00409806201 12/31/2999 12/31/2999J3490 00409818301 12/31/2999 12/31/2999J3490 00409963305 12/31/2999 12/31/2999J3490 00469352530 12/31/2999 12/31/2999J3490 00469357550 12/31/2999 12/31/2999J3490 00469650189 12/31/2999 12/31/2999J3490 00517041010 12/31/2999 12/31/2999J3490 00517051025 12/31/2999 12/31/2999J3490 00517078010 12/31/2999 12/31/2999J3490 00517078110 12/31/2999 12/31/2999J3490 00517101905 10/31/2012 12/31/2999J3490 00517102025 12/31/2999 12/31/2999

Page 113: *This document is a compilation of NDC:HCPCS combinations

J3490 00517135501 12/31/2999 12/31/2999J3490 00517135525 12/31/2999 12/31/2999J3490 00517205325 12/31/2999 12/31/2999J3490 00517209625 12/31/2999 12/31/2999J3490 00517230525 12/31/2999 12/31/2999J3490 00517231525 12/31/2999 12/31/2999J3490 00517235025 12/31/2999 12/31/2999J3490 00517271025 12/31/2999 12/31/2999J3490 00517306501 12/31/2999 12/31/2999J3490 00517460125 12/31/2999 12/31/2999J3490 00517460225 12/31/2999 12/31/2999J3490 00517460525 12/31/2999 12/31/2999J3490 00517462025 12/31/2999 12/31/2999J3490 00517481025 12/31/2999 12/31/2999J3490 00517501901 8/31/2013 12/31/2999J3490 00517502325 12/31/2999 12/31/2999J3490 00517502425 12/31/2999 12/31/2999J3490 00517505001 12/31/2999 12/31/2999J3490 00517621025 12/31/2999 12/31/2999J3490 00517912025 12/31/2999 12/31/2999J3490 00548330400 10/31/2014 1/25/2013J3490 00548335200 10/31/2014 11/28/2012J3490 00548339000 9/30/2014 11/20/2012J3490 00548824100 12/31/2999 4/1/2004J3490 00548824200 12/31/2999 4/1/2004J3490 00548824300 12/31/2999 4/1/2004J3490 00641276443 12/31/2999 4/4/2006J3490 00641276543 12/31/2999 4/4/2006J3490 00641276641 12/31/2999 4/4/2006J3490 00641296541 12/31/2013 12/31/2999J3490 00641296545 12/31/2013 12/31/2999J3490 00641600710 12/31/2999 12/31/2999J3490 00641600810 12/31/2999 12/31/2999J3490 00641601310 12/31/2999 12/31/2999J3490 00641601410 12/31/2999 12/31/2999J3490 00641601510 12/31/2999 12/31/2999J3490 00641601806 12/31/2999 12/31/2999J3490 00641602110 12/31/2999 12/31/2999J3490 00641602225 12/31/2999 12/31/2999J3490 00641602325 12/31/2999 12/31/2999J3490 00641603110 12/31/2999 12/31/2999J3490 00641603210 12/31/2999 12/31/2999J3490 00641603325 12/31/2999 12/31/2999J3490 00641603425 12/31/2999 12/31/2999J3490 00641603525 12/31/2999 12/31/2999J3490 00641603610 12/31/2999 12/31/2999J3490 00641610425 12/31/2999 12/31/2999

Page 114: *This document is a compilation of NDC:HCPCS combinations

J3490 00641610525 12/31/2999 12/31/2999J3490 00641610625 12/31/2999 12/31/2999J3490 00641610710 12/31/2999 12/31/2999J3490 00703291403 12/31/2999 12/31/2999J3490 00703292503 12/31/2999 12/31/2999J3490 00703840104 12/31/2999 12/31/2999J3490 00703841104 12/31/2999 12/31/2999J3490 00703903203 12/31/2999 12/31/2999J3490 00703904003 12/31/2999 12/31/2999J3490 00703950303 12/31/2999 12/31/2999J3490 00703951403 12/31/2999 12/31/2999J3490 00703952601 12/31/2999 12/31/2999J3490 00781300370 12/31/2999 12/31/2999J3490 00781300375 12/31/2999 12/31/2999J3490 00781300392 12/31/2999 12/31/2999J3490 00781300395 12/31/2999 12/31/2999J3490 00781305271 12/31/2999 12/31/2999J3490 00781305295 12/31/2999 12/31/2999J3490 00781307195 12/31/2999 12/31/2999J3490 00781312485 12/31/2999 12/31/2999J3490 00781312495 12/31/2999 12/31/2999J3490 00781312585 12/31/2999 12/31/2999J3490 00781312592 12/31/2999 12/31/2999J3490 00781312595 12/31/2999 12/31/2999J3490 00781312646 12/31/2999 12/31/2999J3490 00781312695 12/31/2999 12/31/2999J3490 00781312892 12/31/2999 12/31/2999J3490 00781312992 12/31/2999 12/31/2999J3490 00781315972 12/31/2999 12/31/2999J3490 00781328809 12/31/2999 12/31/2999J3490 00781328909 12/31/2999 12/31/2999J3490 00781329009 12/31/2999 12/31/2999J3490 00781615395 12/31/2999 12/31/2999J3490 00781912495 12/31/2999 12/31/2999J3490 00781912595 12/31/2999 12/31/2999J3490 00781912695 12/31/2999 12/31/2999J3490 00781922492 12/31/2999 12/31/2999J3490 00781922592 12/31/2999 12/31/2999J3490 10019001571 12/31/2999 4/16/2002J3490 10019001602 4/30/2014 10/10/2012J3490 10019001617 3/31/2014 10/10/2012J3490 10019001629 4/30/2014 10/10/2012J3490 10019001636 1/31/2014 7/25/2012J3490 10019001637 3/31/2014 10/10/2012J3490 10019001639 3/31/2014 9/7/2012J3490 10019001654 1/31/2014 7/25/2012J3490 10019001681 3/31/2014 9/7/2012

Page 115: *This document is a compilation of NDC:HCPCS combinations

J3490 10019004502 3/31/2014 5/4/2012J3490 10019004517 3/31/2014 5/4/2012J3490 10019004603 2/28/2014 11/13/2012J3490 10019004604 1/31/2014 11/13/2012J3490 10019004614 1/31/2014 5/31/2005J3490 10019004663 2/28/2014 11/13/2012J3490 10019005006 3/31/2014 5/4/2012J3490 10019005021 11/30/2013 5/4/2012J3490 10019005036 3/31/2014 5/4/2012J3490 10019005037 11/30/2013 5/4/2012J3490 10019005561 12/31/2999 12/31/2999J3490 10019006001 12/31/2999 4/5/2006J3490 10019006002 12/31/2999 4/5/2006J3490 10019007587 12/31/2999 12/31/2999J3490 10019009503 12/31/2999 2/28/2006J3490 10019009504 12/31/2999 3/10/2005J3490 10019011501 12/31/2999 12/31/2999J3490 10019011539 12/31/2999 12/31/2999J3490 10019012001 12/31/2999 12/31/2999J3490 10019021004 12/31/2999 9/30/2008J3490 10019032102 1/31/2013 9/7/2012J3490 10019032162 1/31/2013 9/7/2012J3490 10019048202 12/31/2999 3/4/2003J3490 10019050602 12/31/2999 12/31/2999J3490 10019050610 5/31/2013 4/3/2012J3490 10019050636 5/31/2013 4/3/2012J3490 10019050637 2/28/2013 4/3/2012J3490 10019050639 12/31/2999 12/31/2999J3490 10019050645 2/28/2013 4/3/2012J3490 10019051001 9/30/2013 1/6/2012J3490 10019051002 8/31/2013 1/6/2012J3490 10019051004 9/30/2013 1/6/2012J3490 10019051078 8/31/2013 1/6/2012J3490 10019051079 9/30/2013 1/6/2012J3490 10139007501 12/31/2999 9/23/2011J3490 10139007502 12/31/2999 9/23/2011J3490 10139007505 12/31/2999 9/23/2011J3490 10139007510 12/31/2999 9/23/2011J3490 10139007512 12/31/2999 9/23/2011J3490 10139007515 12/31/2999 9/23/2011J3490 11098006020 12/31/2999 4/26/2005J3490 15054006001 12/31/2999 12/31/2999J3490 15054009001 12/31/2999 12/31/2999J3490 15054050001 12/31/2999 12/31/2999J3490 15054104005 12/31/2999 12/31/2999J3490 17478006702 12/31/2999 12/31/2999J3490 17478006705 12/31/2999 12/31/2999

Page 116: *This document is a compilation of NDC:HCPCS combinations

J3490 17478012050 12/31/2999 12/31/2999J3490 17478012150 12/31/2999 12/31/2999J3490 17478012250 12/31/2999 12/31/2999J3490 17478015142 12/31/2999 12/31/2999J3490 17478042020 12/31/2999 12/31/2999J3490 17478042040 12/31/2999 12/31/2999J3490 17478093705 12/31/2999 12/31/2999J3490 17478093710 12/31/2999 12/31/2999J3490 17478093725 12/31/2999 12/31/2999J3490 23360003105 12/31/2999 5/1/2011J3490 23360003110 12/31/2999 5/1/2011J3490 24208041601 12/31/2999 12/31/2999J3490 25021011502 12/31/2999 12/31/2999J3490 25021011504 12/31/2999 12/31/2999J3490 25021011506 12/31/2999 12/31/2999J3490 25021011551 12/31/2999 12/31/2999J3490 25021013182 12/31/2999 5/31/2010J3490 25021030020 12/31/2999 12/31/2999J3490 25021030040 12/31/2999 12/31/2999J3490 25021030305 12/31/2999 12/31/2999J3490 25021060005 12/31/2999 12/31/2999J3490 25021060010 12/31/2999 12/31/2999J3490 25021065710 12/31/2999 6/13/2013J3490 25021065820 12/31/2999 12/31/2999J3490 25021067410 12/31/2999 12/31/2999J3490 25021067420 12/31/2999 12/31/2999J3490 25682000101 12/31/2999 12/31/2999J3490 36000002612 12/31/2999 12/31/2999J3490 36000002712 12/31/2999 12/31/2999J3490 36000003310 12/31/2999 12/31/2999J3490 38779052405 12/31/2999 12/31/2999J3490 38779056106 12/31/2999 12/31/2999J3490 38779073104 12/31/2999 12/31/2999J3490 39822027702 12/31/2999 12/31/2999J3490 39822027705 12/31/2999 3/31/2012J3490 39822027707 12/31/2999 3/31/2012J3490 41616093140 12/31/2999 12/31/2999J3490 41616093144 12/31/2999 12/31/2999J3490 41616093244 12/31/2999 12/31/2999J3490 42023010501 12/31/2999 12/31/2999J3490 42023010601 12/31/2999 12/31/2999J3490 42023011310 12/31/2999 12/31/2999J3490 42023011410 12/31/2999 12/31/2999J3490 42023011510 12/31/2999 12/31/2999J3490 42023011725 12/31/2999 12/31/2999J3490 44087111201 12/31/2999 12/31/2999J3490 44087111301 12/31/2999 12/31/2999

Page 117: *This document is a compilation of NDC:HCPCS combinations

J3490 44087111401 12/31/2999 12/31/2999J3490 44087115001 12/31/2999 12/31/2999J3490 44087201003 12/31/2999 5/20/2013J3490 44087900501 12/31/2999 12/31/2999J3490 44087900506 12/31/2999 12/31/2999J3490 44087903001 12/31/2999 12/31/2999J3490 44087907001 12/31/2999 12/31/2999J3490 47783010101 12/31/2999 12/31/2999J3490 48818000101 12/31/2999 12/31/2999J3490 48818000102 12/31/2999 12/31/2999J3490 50242008001 12/31/2999 12/31/2999J3490 50242008201 12/31/2999 12/31/2999J3490 50242013501 12/31/2999 12/31/2999J3490 50242013601 12/31/2999 12/31/2999J3490 50242013701 12/31/2999 12/31/2999J3490 50242014501 12/31/2999 12/31/2999J3490 50419042201 12/31/2999 12/31/2999J3490 50458040101 12/31/2999 12/31/2999J3490 50458040102 12/31/2999 12/31/2999J3490 50458056001 12/31/2999 12/31/2999J3490 50458056101 12/31/2999 12/31/2999J3490 50458056201 12/31/2999 12/31/2999J3490 50458056301 12/31/2999 12/31/2999J3490 50458056401 12/31/2999 12/31/2999J3490 50474000263 12/31/2999 12/31/2999J3490 50474070062 12/31/2999 12/31/2999J3490 50633021011 12/31/2999 12/31/2999J3490 51144005001 12/31/2999 12/31/2999J3490 54092070001 12/31/2999 12/31/2999J3490 54569166000 12/31/2999 1/31/2003J3490 54569326000 12/31/2999 5/5/2011J3490 54569391600 12/31/2999 1/31/2003J3490 54569482100 12/31/2999 1/31/2003J3490 54569532200 12/31/2999 6/1/2003J3490 54569578100 12/31/2999 12/31/2999J3490 54868074100 12/31/2999 6/30/2011J3490 54868076500 12/31/2999 9/7/2012J3490 54868173800 12/31/2999 9/30/2011J3490 54868179500 12/31/2999 6/30/2012J3490 54868179801 12/31/2999 6/30/2012J3490 54868206400 12/31/2999 6/30/2012J3490 54868206401 12/31/2999 6/30/2012J3490 54868313400 12/31/2999 7/31/2011J3490 54868313401 12/31/2999 12/31/2999J3490 54868323101 12/31/2999 6/30/2001J3490 54868339200 12/31/2999 6/30/2011J3490 54868343700 12/31/2999 6/30/2012

Page 118: *This document is a compilation of NDC:HCPCS combinations

J3490 54868369400 12/31/2999 6/30/2003J3490 54868369500 12/31/2999 6/30/2011J3490 54868372700 12/31/2999 6/30/2011J3490 54868380900 12/31/2999 6/30/2011J3490 54868380901 12/31/2999 6/30/2011J3490 54868392000 12/31/2999 2/10/2009J3490 54868415400 12/31/2999 6/30/2011J3490 54868416900 12/31/2999 6/30/2010J3490 54868439900 12/31/2999 6/30/2012J3490 54868448600 12/31/2999 6/30/2011J3490 54868459600 12/31/2999 6/30/2011J3490 54868462900 12/31/2999 6/30/2011J3490 54868488700 12/31/2999 6/30/2011J3490 54868503600 12/31/2999 6/30/2011J3490 54868503601 12/31/2999 6/30/2011J3490 54868509300 12/31/2999 6/30/2011J3490 54868571500 12/31/2999 12/31/2999J3490 54868571800 12/31/2999 6/30/2011J3490 54868572300 12/31/2999 6/30/2012J3490 54868572600 12/31/2999 6/30/2012J3490 54868574000 12/31/2999 12/31/2999J3490 54868574001 12/31/2999 12/31/2999J3490 54868626700 12/31/2999 12/31/2999J3490 55150016710 12/31/2999 12/31/2999J3490 55150016830 12/31/2999 12/31/2999J3490 55150016910 12/31/2999 12/31/2999J3490 55150017030 12/31/2999 12/31/2999J3490 55150017110 12/31/2999 12/31/2999J3490 55150017230 12/31/2999 12/31/2999J3490 55390001010 12/31/2999 12/31/2999J3490 55390001110 12/31/2999 12/31/2999J3490 55390002601 12/31/2999 12/31/2999J3490 55390002701 12/31/2999 12/31/2999J3490 55390002810 12/31/2999 12/31/2999J3490 55390002910 12/31/2999 12/31/2999J3490 55390003501 12/31/2999 12/31/2999J3490 55390003710 12/31/2999 12/31/2999J3490 55390003910 12/31/2999 12/31/2999J3490 55390004210 12/31/2999 5/2/2011J3490 55390006210 12/31/2999 12/31/2999J3490 55390007310 12/31/2999 12/31/2999J3490 55390009210 12/31/2999 12/31/2999J3490 55390009310 12/31/2999 12/31/2999J3490 55390010601 12/31/2999 12/31/2999J3490 55390012301 12/31/2999 12/31/2999J3490 55390013020 12/31/2999 12/31/2999J3490 55390013040 12/31/2999 12/31/2999

Page 119: *This document is a compilation of NDC:HCPCS combinations

J3490 55390022502 12/31/2999 5/2/2011J3490 55390022602 12/31/2999 12/31/2999J3490 55390022604 12/31/2999 12/31/2999J3490 55390034010 12/31/2999 4/18/2013J3490 55390034810 12/31/2999 4/18/2013J3490 55390047510 12/31/2999 12/31/2999J3490 55390050002 12/31/2999 12/31/2999J3490 55390050005 12/31/2999 12/31/2999J3490 55390050010 12/31/2999 12/31/2999J3490 55390056505 12/31/2999 12/31/2999J3490 55390056510 12/31/2999 12/31/2999J3490 55390056530 12/31/2999 12/31/2999J3490 55390056605 12/31/2999 4/18/2013J3490 55390056610 12/31/2999 4/18/2013J3490 55390056630 12/31/2999 4/18/2013J3490 55390076210 12/31/2999 12/31/2999J3490 55390076320 12/31/2999 12/31/2999J3490 55513022101 12/31/2999 12/31/2999J3490 55513022201 12/31/2999 12/31/2999J3490 55513071001 12/31/2999 12/31/2999J3490 55513073001 12/31/2999 12/31/2999J3490 55513095401 12/31/2999 12/31/2999J3490 55513095601 12/31/2999 12/31/2999J3490 57894006003 12/31/2999 12/31/2999J3490 58016499601 12/31/2999 11/29/2012J3490 58016933101 12/31/2999 11/29/2012J3490 58016934301 12/31/2999 10/17/2012J3490 58281056001 12/31/2999 12/31/2999J3490 58281056301 12/31/2999 12/31/2999J3490 58394001201 12/31/2999 12/31/2999J3490 58394001301 12/31/2999 12/31/2999J3490 58394001401 12/31/2999 12/31/2999J3490 58394001501 12/31/2999 12/31/2999J3490 58468015001 12/31/2999 12/31/2999J3490 58468016001 12/31/2999 12/31/2999J3490 59075072010 4/1/2013 1/31/2011J3490 59075072210 4/1/2013 1/31/2011J3490 59148001665 12/31/2999 12/31/2999J3490 59148001871 12/31/2999 12/31/2999J3490 59148001971 12/31/2999 12/31/2999J3490 59338077501 12/31/2999 12/31/2999J3490 59338077510 12/31/2999 12/31/2999J3490 59730560101 12/31/2999 1/9/2009J3490 60505070401 12/31/2999 2/3/2006J3490 60505070402 12/31/2999 2/3/2006J3490 60505071700 12/31/2999 10/1/2011J3490 60505071701 12/31/2999 7/3/2006

Page 120: *This document is a compilation of NDC:HCPCS combinations

J3490 60505071702 12/31/2999 8/1/2008J3490 60505071703 12/31/2999 8/1/2008J3490 60977014402 6/30/2013 5/4/2012J3490 60977014463 6/30/2013 5/4/2012J3490 60977015501 3/31/2014 10/19/2012J3490 60977015502 3/31/2014 10/19/2012J3490 60977015503 1/31/2014 7/25/2012J3490 60977015504 12/31/2999 2/22/2006J3490 60977015506 10/31/2013 7/25/2012J3490 60977015554 1/31/2014 7/25/2012J3490 61553018948 12/31/2999 12/31/2999J3490 61553019048 12/31/2999 12/31/2999J3490 61553019148 12/31/2999 12/31/2999J3490 61553019202 12/31/2999 12/31/2999J3490 61553019341 12/31/2999 12/31/2999J3490 61553019448 12/31/2999 12/31/2999J3490 61553022802 12/31/2999 12/31/2999J3490 61553024337 12/31/2999 12/31/2999J3490 61553024802 12/31/2999 12/31/2999J3490 61703021309 12/31/2999 5/24/2002J3490 61703021311 12/31/2999 5/24/2002J3490 61703021321 12/31/2999 5/24/2002J3490 61703023322 12/31/2999 8/1/2006J3490 61703023341 12/31/2999 8/1/2006J3490 61755000502 12/31/2999 12/31/2999J3490 61958090101 12/31/2999 12/31/2999J3490 62856038901 12/31/2999 12/31/2999J3490 63323002605 12/31/2999 12/31/2999J3490 63323003250 12/31/2999 12/31/2007J3490 63323003261 12/31/2999 12/31/2999J3490 63323006620 12/31/2999 12/31/2007J3490 63323006650 12/31/2999 12/31/2007J3490 63323006661 12/31/2999 12/31/2007J3490 63323011410 12/31/2999 12/31/2007J3490 63323013011 12/31/2999 12/31/2999J3490 63323013013 12/31/2999 12/31/2999J3490 63323018410 12/31/2999 12/31/2999J3490 63323018411 12/31/2999 12/31/2999J3490 63323020102 12/31/2999 12/31/2999J3490 63323020110 12/31/2999 12/31/2999J3490 63323020202 12/31/2999 12/31/2999J3490 63323020805 12/31/2999 12/31/2999J3490 63323026920 12/31/2999 3/7/2013J3490 63323026927 12/31/2999 12/31/2999J3490 63323026929 12/31/2999 12/31/2999J3490 63323026937 12/31/2999 12/31/2999J3490 63323026950 12/31/2999 12/31/2999

Page 121: *This document is a compilation of NDC:HCPCS combinations

J3490 63323026957 12/31/2999 12/31/2999J3490 63323026959 12/31/2999 12/31/2999J3490 63323026965 12/31/2999 12/31/2999J3490 63323026967 12/31/2999 12/31/2999J3490 63323026969 12/31/2999 12/31/2999J3490 63323026994 12/31/2999 12/31/2999J3490 63323027025 12/31/2999 12/31/2999J3490 63323027026 12/31/2999 12/31/2999J3490 63323027027 1/30/2013 6/8/2011J3490 63323027050 12/31/2999 12/31/2999J3490 63323027057 12/31/2999 12/31/2999J3490 63323027065 12/31/2999 12/31/2999J3490 63323027067 12/31/2999 12/31/2999J3490 63323028202 12/31/2999 12/31/2999J3490 63323028204 12/31/2999 12/31/2999J3490 63323028206 12/31/2999 12/31/2999J3490 63323028260 12/31/2999 12/31/2999J3490 63323029730 12/31/2999 12/31/2999J3490 63323029731 12/31/2999 2/1/2013J3490 63323029750 12/31/2999 12/31/2999J3490 63323029751 12/31/2999 2/1/2013J3490 63323029753 12/31/2999 2/1/2013J3490 63323029766 12/31/2999 12/31/2999J3490 63323030201 12/31/2999 12/31/2999J3490 63323032930 12/31/2999 12/31/2999J3490 63323038120 12/31/2999 3/23/2011J3490 63323038510 12/31/2999 12/31/2999J3490 63323038620 12/31/2999 12/31/2999J3490 63323039050 12/31/2999 3/23/2011J3490 63323040120 12/31/2999 12/31/2999J3490 63323040220 12/31/2999 12/31/2999J3490 63323042405 12/31/2999 12/31/2999J3490 63323042410 12/31/2999 12/31/2999J3490 63323046410 4/30/2015 11/8/2011J3490 63323046417 12/31/2999 12/31/2999J3490 63323046430 9/30/2014 1/21/2011J3490 63323046431 12/31/2999 12/31/2999J3490 63323046433 12/31/2999 12/31/2999J3490 63323046437 12/31/2999 12/31/2999J3490 63323046550 3/30/2015 9/8/2011J3490 63323046557 12/31/2999 12/31/2999J3490 63323046610 5/30/2014 5/18/2011J3490 63323046617 12/31/2999 12/31/2999J3490 63323046630 12/30/2013 2/4/2011J3490 63323046631 12/31/2999 12/31/2999J3490 63323046633 12/31/2999 12/31/2999J3490 63323046637 12/31/2999 12/31/2999

Page 122: *This document is a compilation of NDC:HCPCS combinations

J3490 63323046750 3/30/2015 6/24/2011J3490 63323046757 12/31/2999 12/31/2999J3490 63323047210 12/31/2999 2/13/2012J3490 63323047217 12/31/2999 12/31/2999J3490 63323047230 6/30/2013 3/2/2011J3490 63323047233 12/31/2999 12/31/2999J3490 63323047237 12/31/2999 12/31/2999J3490 63323048520 10/30/2014 4/26/2011J3490 63323048550 3/30/2015 9/27/2011J3490 63323048610 5/30/2014 9/21/2011J3490 63323048620 12/30/2014 9/8/2011J3490 63323049089 12/31/2999 12/31/2999J3490 63323049150 11/30/2013 1/6/2011J3490 63323049202 4/30/2015 8/2/2011J3490 63323049205 3/30/2014 1/20/2011J3490 63323049230 6/30/2014 1/21/2011J3490 63323049231 12/31/2999 12/31/2999J3490 63323049280 12/31/2999 12/31/2999J3490 63323049289 12/31/2999 12/31/2999J3490 63323049297 12/31/2999 12/31/2999J3490 63323049391 12/31/2999 12/31/2999J3490 63323049397 12/31/2999 12/31/2999J3490 63323049405 12/31/2999 12/31/2999J3490 63323049502 12/30/2014 11/30/2010J3490 63323049505 1/30/2015 4/1/2011J3490 63323049680 12/31/2999 12/31/2999J3490 63323049697 12/31/2999 12/31/2999J3490 63323049889 12/31/2999 12/31/2999J3490 63323065210 12/31/2999 12/31/2999J3490 63323066005 12/31/2999 12/31/2999J3490 63323073804 12/31/2999 11/13/2012J3490 63323073809 12/31/2999 12/31/2999J3490 63323073820 12/31/2999 12/31/2999J3490 63323073912 12/31/2999 12/31/2999J3490 63370010535 12/31/2999 4/2/2012J3490 63459039120 12/31/2999 12/31/2999J3490 63833082502 12/31/2999 12/31/2999J3490 64208823401 12/31/2999 12/31/2999J3490 64208823402 12/31/2999 12/31/2999J3490 64208823403 12/31/2999 12/31/2999J3490 65293000200 12/31/2999 10/3/2011J3490 65293000211 5/31/2012 10/3/2011J3490 65293000250 12/31/2999 10/3/2011J3490 65293000255 5/31/2012 10/3/2011J3490 65293000500 12/31/2999 12/31/2999J3490 65293000511 12/31/2999 12/31/2999J3490 65293000550 12/31/2999 12/31/2999

Page 123: *This document is a compilation of NDC:HCPCS combinations

J3490 65293000555 12/31/2999 12/31/2999J3490 65483035502 12/31/2999 2/10/2009J3490 65483035504 12/31/2999 2/10/2009J3490 66302020601 12/31/2999 12/31/2999J3490 66302020602 12/31/2999 12/31/2999J3490 66302020603 12/31/2999 12/31/2999J3490 66479002539 12/31/2999 5/13/2005J3490 66658023407 12/31/2999 12/31/2999J3490 66658023428 12/31/2999 12/31/2999J3490 66860012002 12/31/2999 12/31/2999J3490 66887000301 12/31/2999 12/31/2999J3490 67263034260 12/31/2999 5/1/2011J3490 67457000110 12/31/2999 12/31/2999J3490 67457010810 12/31/2999 12/31/2999J3490 67457011850 12/31/2999 12/31/2999J3490 67457018120 12/31/2999 12/31/2999J3490 67457018210 12/31/2999 12/31/2999J3490 67457018320 12/31/2999 12/31/2999J3490 67457018750 12/31/2999 12/31/2999J3490 67457019015 12/31/2999 12/31/2999J3490 67457019115 12/31/2999 9/1/2011J3490 67457019205 12/31/2999 12/31/2999J3490 67467018101 2/12/2013 12/31/2999J3490 67467018102 9/15/2013 12/31/2999J3490 68135002001 12/31/2999 12/31/2999J3490 76075010101 12/31/2999 12/31/2999J3490 76125090001 12/31/2999 12/31/2999J3490 76125090010 12/31/2999 12/31/2999J3490 76125090020 12/31/2999 12/31/2999J3490 76125090025 12/31/2999 12/31/2999J3490 76125090050 12/31/2999 12/31/2999J3490 85836015153 12/31/2999 12/31/2999J3535 00597008717 12/31/2999 12/31/2999J3535 54569575700 12/31/2999 12/31/2999J3535 54868551100 12/31/2999 12/31/2999J3590 00002759701 12/31/2999 12/31/2999J3590 00002763511 12/31/2999 12/31/2999J3590 00002763611 12/31/2999 12/31/2999J3590 00002763711 12/31/2999 12/31/2999J3590 00003037113 12/31/2999 12/31/2999J3590 00003223011 12/31/2999 12/31/2999J3590 00003224011 12/31/2999 12/31/2999J3590 00003256016 12/31/2999 12/31/2999J3590 00003257016 12/31/2999 12/31/2999J3590 00004035009 12/31/2999 12/31/2999J3590 00004691106 1/31/2013 1/31/2013J3590 00008092351 12/31/2999 12/31/2999

Page 124: *This document is a compilation of NDC:HCPCS combinations

J3590 00008092355 12/31/2999 12/31/2999J3590 00008117901 12/31/2999 12/31/2999J3590 00008117905 12/31/2999 12/31/2999J3590 00009023301 12/31/2999 12/31/2999J3590 00009023344 4/1/2013 1/1/2011J3590 00009043624 12/31/2999 2/26/2013J3590 00009072809 12/31/2999 12/31/2999J3590 00009077526 12/31/2999 12/31/2999J3590 00009087026 12/31/2999 12/31/2999J3590 00009090211 12/31/2999 12/31/2999J3590 00009090218 12/31/2999 12/31/2999J3590 00009312403 12/31/2999 12/31/2999J3590 00009337502 12/31/2999 12/31/2999J3590 00009338102 12/31/2999 12/31/2999J3590 00009338201 12/31/2999 12/31/2999J3590 00009338202 12/31/2999 12/31/2999J3590 00009344703 12/31/2999 12/31/2999J3590 00015191012 12/31/2999 12/31/2999J3590 00015191113 12/31/2999 12/31/2999J3590 00023334807 12/31/2999 12/31/2999J3590 00024582411 12/31/2999 12/31/2999J3590 00024584001 12/31/2999 12/31/2999J3590 00024584101 12/31/2999 12/31/2999J3590 00029657126 12/31/2999 12/31/2999J3590 00029657131 12/31/2999 12/31/2999J3590 00029657921 12/31/2999 12/31/2999J3590 00065054301 12/31/2999 12/31/2999J3590 00068059701 12/31/2999 12/31/2999J3590 00069000601 12/31/2999 12/31/2999J3590 00069000603 12/31/2999 12/31/2999J3590 00069009303 12/31/2999 12/31/2999J3590 00069009402 12/31/2999 12/31/2999J3590 00069010404 12/31/2999 12/31/2999J3590 00069010503 12/31/2999 12/31/2999J3590 00069010601 12/31/2999 12/31/2999J3590 00069010805 12/31/2999 12/31/2999J3590 00069011201 12/31/2999 12/31/2999J3590 00069012102 12/31/2999 12/31/2999J3590 00069012502 12/31/2999 12/31/2999J3590 00069012602 12/31/2999 12/31/2999J3590 00069014101 12/31/2999 1/30/2013J3590 00074114315 12/31/2999 7/19/2011J3590 00074156410 12/31/2999 12/31/2999J3590 00074229111 12/31/2999 5/2/2011J3590 00074400001 12/31/2999 7/19/2011J3590 00078040001 12/31/2999 12/31/2999J3590 00078041420 12/31/2999 12/31/2999

Page 125: *This document is a compilation of NDC:HCPCS combinations

J3590 00078041520 12/31/2999 12/31/2999J3590 00078041720 12/31/2999 12/31/2999J3590 00078058261 12/31/2999 12/31/2999J3590 00143966010 12/31/2999 12/31/2999J3590 00143967910 12/31/2999 12/31/2999J3590 00143968025 12/31/2999 12/31/2999J3590 00143968125 12/31/2999 12/31/2999J3590 00143968225 12/31/2999 12/31/2999J3590 00143968310 12/31/2999 12/31/2999J3590 00143968410 12/31/2999 12/31/2999J3590 00143977226 12/31/2999 5/13/2011J3590 00143978310 12/31/2999 12/31/2999J3590 00143978410 12/31/2999 12/31/2999J3590 00143978610 12/31/2999 12/31/2999J3590 00143978710 12/31/2999 12/31/2999J3590 00143987310 12/31/2999 12/31/2999J3590 00186015501 5/31/2013 7/13/2010J3590 00186024444 12/31/2999 2/1/2013J3590 00186103001 4/30/2013 8/4/2009J3590 00186103101 4/30/2013 11/5/2009J3590 00186103301 5/31/2013 9/16/2009J3590 00186103312 4/30/2013 1/4/2010J3590 00186103501 5/31/2013 9/1/2009J3590 00186103712 12/31/2999 8/4/2009J3590 00186602001 12/31/2999 12/31/2999J3590 00186604001 12/31/2999 12/31/2999J3590 00264553532 12/31/2999 12/31/2999J3590 00264762500 12/31/2999 12/31/2999J3590 00264780510 12/31/2999 12/31/2999J3590 00264780610 12/31/2999 12/31/2999J3590 00310030065 12/31/2999 3/17/2008J3590 00338005403 12/31/2999 12/31/2999J3590 00338005603 12/31/2999 12/31/2999J3590 00338101741 12/31/2999 12/31/2999J3590 00338101948 12/31/2999 12/31/2999J3590 00338104702 12/31/2999 12/31/2999J3590 00338104902 12/31/2999 12/31/2999J3590 00338105102 12/31/2999 12/31/2999J3590 00338105548 12/31/2999 12/31/2999J3590 00338519741 12/31/2999 12/31/2999J3590 00338519841 12/31/2999 10/18/2008J3590 00407408601 12/31/2999 12/31/2012J3590 00409114402 12/31/2999 12/31/2999J3590 00409115801 12/31/2999 12/31/2999J3590 00409115901 12/31/2999 12/31/2999J3590 00409115902 12/31/2999 12/31/2999J3590 00409116001 12/31/2999 12/31/2999

Page 126: *This document is a compilation of NDC:HCPCS combinations

J3590 00409116101 12/31/2999 12/31/2999J3590 00409116201 12/31/2999 12/31/2999J3590 00409116202 12/31/2999 12/31/2999J3590 00409116301 12/31/2999 12/31/2999J3590 00409116401 12/31/2999 12/31/2999J3590 00409116501 12/31/2999 12/31/2999J3590 00409116502 12/31/2999 12/31/2999J3590 00409117101 12/31/2999 12/31/2999J3590 00409117102 12/31/2999 12/31/2999J3590 00409132305 12/31/2999 12/31/2999J3590 00409141204 12/31/2999 12/31/2999J3590 00409141210 12/31/2999 12/31/2999J3590 00409141249 12/31/2999 12/31/2999J3590 00409141250 12/31/2999 12/31/2999J3590 00409148202 12/31/2999 12/31/2999J3590 00409148302 12/31/2999 12/31/2999J3590 00409148303 12/31/2999 12/31/2999J3590 00409148402 12/31/2999 12/31/2999J3590 00409148403 12/31/2999 12/31/2999J3590 00409155910 12/31/2999 12/31/2999J3590 00409155930 12/31/2999 12/31/2999J3590 00409156010 12/31/2999 12/31/2999J3590 00409156029 12/31/2999 12/31/2999J3590 00409158210 12/31/2999 12/31/2999J3590 00409158229 12/31/2999 12/31/2999J3590 00409158603 12/31/2999 12/31/2999J3590 00409158750 12/31/2999 12/31/2999J3590 00409161050 12/31/2999 12/31/2999J3590 00409163110 12/31/2999 12/31/2999J3590 00409163201 12/31/2999 12/31/2999J3590 00409163249 12/31/2999 12/31/2999J3590 00409163401 12/31/2999 12/31/2999J3590 00409177805 12/31/2999 12/31/2999J3590 00409177835 12/31/2999 12/31/2999J3590 00409205105 12/31/2999 12/31/2999J3590 00409205310 12/31/2999 12/31/2999J3590 00409206605 12/31/2999 12/31/2999J3590 00409212201 12/31/2999 12/31/2999J3590 00409212202 12/31/2999 12/31/2999J3590 00409212213 12/31/2999 12/31/2999J3590 00409212288 12/31/2999 12/31/2999J3590 00409226602 12/31/2999 12/31/2999J3590 00409226605 12/31/2999 12/31/2999J3590 00409226649 12/31/2999 12/31/2999J3590 00409226651 12/31/2999 12/31/2999J3590 00409226720 12/31/2999 12/31/2999J3590 00409226754 12/31/2999 12/31/2999

Page 127: *This document is a compilation of NDC:HCPCS combinations

J3590 00409228505 12/31/2999 12/31/2999J3590 00409233934 12/31/2999 12/31/2999J3590 00409329451 12/31/2999 12/31/2999J3590 00409329905 12/31/2999 12/31/2999J3590 00409329906 12/31/2999 12/31/2999J3590 00409401101 12/31/2999 12/31/2999J3590 00409405001 12/31/2999 12/31/2999J3590 00409405101 12/31/2999 12/31/2999J3590 00409405201 12/31/2999 12/31/2999J3590 00409405303 12/31/2999 12/31/2999J3590 00409405403 12/31/2999 12/31/2999J3590 00409405503 12/31/2999 12/31/2999J3590 00409405601 12/31/2999 12/31/2999J3590 00409419701 12/31/2999 12/31/2999J3590 00409427201 12/31/2999 12/31/2999J3590 00409427301 12/31/2999 12/31/2999J3590 00409427501 6/1/2013 6/1/2013J3590 00409427601 12/31/2999 12/31/2999J3590 00409427602 12/31/2999 12/31/2999J3590 00409427701 12/31/2999 12/31/2999J3590 00409427702 12/31/2999 12/31/2999J3590 00409427801 12/31/2999 12/31/2999J3590 00409428201 12/31/2999 12/31/2999J3590 00409428202 12/31/2999 12/31/2999J3590 00409428301 12/31/2999 12/31/2999J3590 00409434673 12/31/2999 12/31/2999J3590 00409435003 12/31/2999 12/31/2999J3590 00409469924 12/31/2999 12/31/2999J3590 00409469930 12/31/2999 12/31/2999J3590 00409469933 12/31/2999 12/31/2999J3590 00409469962 12/31/2999 12/31/2999J3590 00409477601 12/31/2999 12/31/2999J3590 00409490034 12/31/2999 12/31/2999J3590 00409490334 12/31/2999 12/31/2999J3590 00409491634 12/31/2999 12/31/2999J3590 00409492834 12/31/2999 12/31/2999J3590 00409553434 12/31/2999 12/31/2999J3590 00409562201 12/31/2999 12/31/2999J3590 00409575701 12/31/2999 12/31/2999J3590 00409660902 12/31/2999 12/31/2999J3590 00409662502 12/31/2999 12/31/2999J3590 00409663734 12/31/2999 12/31/2999J3590 00409669501 12/31/2999 12/31/2999J3590 00409669502 12/31/2999 12/31/2999J3590 00409711609 12/31/2999 12/31/2999J3590 00409729501 12/31/2999 5/1/2012J3590 00409729973 12/31/2999 12/31/2999

Page 128: *This document is a compilation of NDC:HCPCS combinations

J3590 00409744401 12/31/2999 12/31/2999J3590 00409744501 12/31/2999 12/31/2999J3590 00409781124 12/31/2999 12/31/2999J3590 00409781137 12/31/2999 12/31/2999J3590 00409790509 12/31/2999 12/31/2999J3590 00409806029 12/31/2999 12/31/2999J3590 00409806101 12/31/2999 12/31/2999J3590 00409806201 12/31/2999 12/31/2999J3590 00409818301 12/31/2999 12/31/2999J3590 00409963305 12/31/2999 12/31/2999J3590 00469352530 12/31/2999 12/31/2999J3590 00469357550 12/31/2999 12/31/2999J3590 00469650189 12/31/2999 12/31/2999J3590 00517041010 12/31/2999 12/31/2999J3590 00517051025 12/31/2999 12/31/2999J3590 00517078010 12/31/2999 12/31/2999J3590 00517078110 12/31/2999 12/31/2999J3590 00517101905 10/31/2012 12/31/2999J3590 00517102025 12/31/2999 12/31/2999J3590 00517135501 12/31/2999 12/31/2999J3590 00517135525 12/31/2999 12/31/2999J3590 00517205325 12/31/2999 12/31/2999J3590 00517209625 12/31/2999 12/31/2999J3590 00517230525 12/31/2999 12/31/2999J3590 00517231525 12/31/2999 12/31/2999J3590 00517235025 12/31/2999 12/31/2999J3590 00517271025 12/31/2999 12/31/2999J3590 00517306501 12/31/2999 12/31/2999J3590 00517460125 12/31/2999 12/31/2999J3590 00517460225 12/31/2999 12/31/2999J3590 00517460525 12/31/2999 12/31/2999J3590 00517462025 12/31/2999 12/31/2999J3590 00517481025 12/31/2999 12/31/2999J3590 00517501901 8/31/2013 12/31/2999J3590 00517502325 12/31/2999 12/31/2999J3590 00517502425 12/31/2999 12/31/2999J3590 00517505001 12/31/2999 12/31/2999J3590 00517621025 12/31/2999 12/31/2999J3590 00517912025 12/31/2999 12/31/2999J3590 00548330400 10/31/2014 1/25/2013J3590 00548335200 10/31/2014 11/28/2012J3590 00548339000 9/30/2014 11/20/2012J3590 00548824100 12/31/2999 4/1/2004J3590 00548824200 12/31/2999 4/1/2004J3590 00548824300 12/31/2999 4/1/2004J3590 00641276443 12/31/2999 4/4/2006J3590 00641276543 12/31/2999 4/4/2006

Page 129: *This document is a compilation of NDC:HCPCS combinations

J3590 00641276641 12/31/2999 4/4/2006J3590 00641296541 12/31/2013 12/31/2999J3590 00641296545 12/31/2013 12/31/2999J3590 00641600710 12/31/2999 12/31/2999J3590 00641600810 12/31/2999 12/31/2999J3590 00641601310 12/31/2999 12/31/2999J3590 00641601410 12/31/2999 12/31/2999J3590 00641601510 12/31/2999 12/31/2999J3590 00641601806 12/31/2999 12/31/2999J3590 00641602110 12/31/2999 12/31/2999J3590 00641602225 12/31/2999 12/31/2999J3590 00641602325 12/31/2999 12/31/2999J3590 00641603110 12/31/2999 12/31/2999J3590 00641603210 12/31/2999 12/31/2999J3590 00641603325 12/31/2999 12/31/2999J3590 00641603425 12/31/2999 12/31/2999J3590 00641603525 12/31/2999 12/31/2999J3590 00641603610 12/31/2999 12/31/2999J3590 00641610425 12/31/2999 12/31/2999J3590 00641610525 12/31/2999 12/31/2999J3590 00641610625 12/31/2999 12/31/2999J3590 00641610710 12/31/2999 12/31/2999J3590 00703291403 12/31/2999 12/31/2999J3590 00703292503 12/31/2999 12/31/2999J3590 00703840104 12/31/2999 12/31/2999J3590 00703841104 12/31/2999 12/31/2999J3590 00703950303 12/31/2999 12/31/2999J3590 00703951403 12/31/2999 12/31/2999J3590 00703952601 12/31/2999 12/31/2999J3590 00781300370 12/31/2999 12/31/2999J3590 00781300375 12/31/2999 12/31/2999J3590 00781300392 12/31/2999 12/31/2999J3590 00781300395 12/31/2999 12/31/2999J3590 00781305271 12/31/2999 12/31/2999J3590 00781305295 12/31/2999 12/31/2999J3590 00781307195 12/31/2999 12/31/2999J3590 00781312485 12/31/2999 12/31/2999J3590 00781312495 12/31/2999 12/31/2999J3590 00781312585 12/31/2999 12/31/2999J3590 00781312592 12/31/2999 12/31/2999J3590 00781312595 12/31/2999 12/31/2999J3590 00781312646 12/31/2999 12/31/2999J3590 00781312695 12/31/2999 12/31/2999J3590 00781312892 12/31/2999 12/31/2999J3590 00781312992 12/31/2999 12/31/2999J3590 00781315972 12/31/2999 12/31/2999J3590 00781328809 12/31/2999 12/31/2999

Page 130: *This document is a compilation of NDC:HCPCS combinations

J3590 00781328909 12/31/2999 12/31/2999J3590 00781329009 12/31/2999 12/31/2999J3590 00781912495 12/31/2999 12/31/2999J3590 00781912595 12/31/2999 12/31/2999J3590 00781912695 12/31/2999 12/31/2999J3590 00781922492 12/31/2999 12/31/2999J3590 00781922592 12/31/2999 12/31/2999J3590 00944417505 12/31/2999 12/31/2999J3590 00944417510 12/31/2999 12/31/2999J3590 10019001571 12/31/2999 4/16/2002J3590 10019001602 4/30/2014 10/10/2012J3590 10019001617 3/31/2014 10/10/2012J3590 10019001629 4/30/2014 10/10/2012J3590 10019001636 1/31/2014 7/25/2012J3590 10019001637 3/31/2014 10/10/2012J3590 10019001639 3/31/2014 9/7/2012J3590 10019001654 1/31/2014 7/25/2012J3590 10019001681 3/31/2014 9/7/2012J3590 10019004502 3/31/2014 5/4/2012J3590 10019004517 3/31/2014 5/4/2012J3590 10019004603 2/28/2014 11/13/2012J3590 10019004604 1/31/2014 11/13/2012J3590 10019004614 1/31/2014 5/31/2005J3590 10019004663 2/28/2014 11/13/2012J3590 10019005561 12/31/2999 12/31/2999J3590 10019006001 12/31/2999 4/5/2006J3590 10019006002 12/31/2999 4/5/2006J3590 10019007587 12/31/2999 12/31/2999J3590 10019009503 12/31/2999 2/28/2006J3590 10019009504 12/31/2999 3/10/2005J3590 10019011501 12/31/2999 12/31/2999J3590 10019011539 12/31/2999 12/31/2999J3590 10019012001 12/31/2999 12/31/2999J3590 10019021004 12/31/2999 9/30/2008J3590 10019032102 1/31/2013 9/7/2012J3590 10019032162 1/31/2013 9/7/2012J3590 10019048202 12/31/2999 3/4/2003J3590 10019050602 12/31/2999 12/31/2999J3590 10019050610 5/31/2013 4/3/2012J3590 10019050636 5/31/2013 4/3/2012J3590 10019050637 2/28/2013 4/3/2012J3590 10019050639 12/31/2999 12/31/2999J3590 10019050645 2/28/2013 4/3/2012J3590 10019051001 9/30/2013 1/6/2012J3590 10019051002 8/31/2013 1/6/2012J3590 10019051004 9/30/2013 1/6/2012J3590 10019051078 8/31/2013 1/6/2012

Page 131: *This document is a compilation of NDC:HCPCS combinations

J3590 10019051079 9/30/2013 1/6/2012J3590 11098006020 12/31/2999 4/26/2005J3590 13533063601 12/31/2999 12/31/2999J3590 13533063602 12/31/2999 12/31/2999J3590 13533063603 12/31/2999 12/31/2999J3590 13533063605 12/31/2999 12/31/2999J3590 15054006001 12/31/2999 12/31/2999J3590 15054009001 12/31/2999 12/31/2999J3590 15054050001 12/31/2999 12/31/2999J3590 17478006702 12/31/2999 12/31/2999J3590 17478006705 12/31/2999 12/31/2999J3590 17478012050 12/31/2999 12/31/2999J3590 17478012150 12/31/2999 12/31/2999J3590 17478012250 12/31/2999 12/31/2999J3590 17478015142 12/31/2999 12/31/2999J3590 17478042020 12/31/2999 12/31/2999J3590 17478042040 12/31/2999 12/31/2999J3590 17478093705 12/31/2999 12/31/2999J3590 17478093710 12/31/2999 12/31/2999J3590 17478093725 12/31/2999 12/31/2999J3590 23360003105 12/31/2999 5/1/2011J3590 23360003110 12/31/2999 5/1/2011J3590 25021011502 12/31/2999 12/31/2999J3590 25021011504 12/31/2999 12/31/2999J3590 25021011506 12/31/2999 12/31/2999J3590 25021011551 12/31/2999 12/31/2999J3590 25021013182 12/31/2999 5/31/2010J3590 25021030020 12/31/2999 12/31/2999J3590 25021030040 12/31/2999 12/31/2999J3590 25021030305 12/31/2999 12/31/2999J3590 25021060005 12/31/2999 12/31/2999J3590 25021060010 12/31/2999 12/31/2999J3590 25021065710 12/31/2999 6/13/2013J3590 25021065820 12/31/2999 12/31/2999J3590 25021067410 12/31/2999 12/31/2999J3590 25021067420 12/31/2999 12/31/2999J3590 36000002612 12/31/2999 12/31/2999J3590 36000002712 12/31/2999 12/31/2999J3590 36000003310 12/31/2999 12/31/2999J3590 39822027702 12/31/2999 12/31/2999J3590 39822027705 12/31/2999 3/31/2012J3590 39822027707 12/31/2999 3/31/2012J3590 41616093140 12/31/2999 12/31/2999J3590 41616093144 12/31/2999 12/31/2999J3590 41616093244 12/31/2999 12/31/2999J3590 42023011310 12/31/2999 12/31/2999J3590 42023011410 12/31/2999 12/31/2999

Page 132: *This document is a compilation of NDC:HCPCS combinations

J3590 42023011510 12/31/2999 12/31/2999J3590 42023011725 12/31/2999 12/31/2999J3590 47783010101 12/31/2999 12/31/2999J3590 48818000101 12/31/2999 12/31/2999J3590 48818000102 12/31/2999 12/31/2999J3590 49999042505 12/31/2999 12/31/2999J3590 50242006001 12/31/2999 12/31/2999J3590 50242013501 12/31/2999 12/31/2999J3590 50242013601 12/31/2999 12/31/2999J3590 50242013701 12/31/2999 12/31/2999J3590 50242014501 12/31/2999 12/31/2999J3590 50458040101 12/31/2999 12/31/2999J3590 50458040102 12/31/2999 12/31/2999J3590 50458056001 12/31/2999 12/31/2999J3590 50458056101 12/31/2999 12/31/2999J3590 50458056201 12/31/2999 12/31/2999J3590 50458056301 12/31/2999 12/31/2999J3590 50458056401 12/31/2999 12/31/2999J3590 50474000263 12/31/2999 12/31/2999J3590 50474070062 12/31/2999 12/31/2999J3590 50633021011 12/31/2999 12/31/2999J3590 51144005001 12/31/2999 12/31/2999J3590 54569166000 12/31/2999 1/31/2003J3590 54569326000 12/31/2999 5/5/2011J3590 54569391600 12/31/2999 1/31/2003J3590 54569473900 12/31/2999 9/1/2008J3590 54569482100 12/31/2999 1/31/2003J3590 54569532200 12/31/2999 6/1/2003J3590 54868074100 12/31/2999 6/30/2011J3590 54868076500 12/31/2999 9/7/2012J3590 54868173800 12/31/2999 9/30/2011J3590 54868179500 12/31/2999 6/30/2012J3590 54868179801 12/31/2999 6/30/2012J3590 54868206400 12/31/2999 6/30/2012J3590 54868206401 12/31/2999 6/30/2012J3590 54868313400 12/31/2999 7/31/2011J3590 54868313401 12/31/2999 12/31/2999J3590 54868323101 12/31/2999 6/30/2001J3590 54868339200 12/31/2999 6/30/2011J3590 54868343700 12/31/2999 6/30/2012J3590 54868369500 12/31/2999 6/30/2011J3590 54868380900 12/31/2999 6/30/2011J3590 54868380901 12/31/2999 6/30/2011J3590 54868392000 12/31/2999 2/10/2009J3590 54868415400 12/31/2999 6/30/2011J3590 54868416900 12/31/2999 6/30/2010J3590 54868439900 12/31/2999 6/30/2012

Page 133: *This document is a compilation of NDC:HCPCS combinations

J3590 54868448600 12/31/2999 6/30/2011J3590 54868459600 12/31/2999 6/30/2011J3590 54868462900 12/31/2999 6/30/2011J3590 54868488700 12/31/2999 6/30/2011J3590 54868509300 12/31/2999 6/30/2011J3590 54868571500 12/31/2999 12/31/2999J3590 54868572300 12/31/2999 6/30/2012J3590 54868572600 12/31/2999 6/30/2012J3590 54868574000 12/31/2999 12/31/2999J3590 54868574001 12/31/2999 12/31/2999J3590 54868626700 12/31/2999 12/31/2999J3590 55150016710 12/31/2999 12/31/2999J3590 55150016830 12/31/2999 12/31/2999J3590 55150016910 12/31/2999 12/31/2999J3590 55150017030 12/31/2999 12/31/2999J3590 55150017110 12/31/2999 12/31/2999J3590 55150017230 12/31/2999 12/31/2999J3590 55390001010 12/31/2999 12/31/2999J3590 55390001110 12/31/2999 12/31/2999J3590 55390002601 12/31/2999 12/31/2999J3590 55390002701 12/31/2999 12/31/2999J3590 55390002810 12/31/2999 12/31/2999J3590 55390002910 12/31/2999 12/31/2999J3590 55390003501 12/31/2999 12/31/2999J3590 55390003710 12/31/2999 12/31/2999J3590 55390003910 12/31/2999 12/31/2999J3590 55390006210 12/31/2999 12/31/2999J3590 55390007310 12/31/2999 12/31/2999J3590 55390009210 12/31/2999 12/31/2999J3590 55390009310 12/31/2999 12/31/2999J3590 55390010601 12/31/2999 12/31/2999J3590 55390012301 12/31/2999 12/31/2999J3590 55390013020 12/31/2999 12/31/2999J3590 55390013040 12/31/2999 12/31/2999J3590 55390034010 12/31/2999 4/18/2013J3590 55390034810 12/31/2999 4/18/2013J3590 55390047510 12/31/2999 12/31/2999J3590 55390050002 12/31/2999 12/31/2999J3590 55390050005 12/31/2999 12/31/2999J3590 55390050010 12/31/2999 12/31/2999J3590 55390056505 12/31/2999 12/31/2999J3590 55390056510 12/31/2999 12/31/2999J3590 55390056530 12/31/2999 12/31/2999J3590 55390056605 12/31/2999 4/18/2013J3590 55390056610 12/31/2999 4/18/2013J3590 55390056630 12/31/2999 4/18/2013J3590 55390076210 12/31/2999 12/31/2999

Page 134: *This document is a compilation of NDC:HCPCS combinations

J3590 55390076320 12/31/2999 12/31/2999J3590 55513071001 12/31/2999 12/31/2999J3590 55513073001 12/31/2999 12/31/2999J3590 57894006003 12/31/2999 12/31/2999J3590 58016499601 12/31/2999 11/29/2012J3590 58016933101 12/31/2999 11/29/2012J3590 58016934301 12/31/2999 10/17/2012J3590 58394001201 12/31/2999 12/31/2999J3590 58394001301 12/31/2999 12/31/2999J3590 58394001401 12/31/2999 12/31/2999J3590 58394001501 12/31/2999 12/31/2999J3590 58468015001 12/31/2999 12/31/2999J3590 58468016001 12/31/2999 12/31/2999J3590 59338077501 12/31/2999 12/31/2999J3590 59338077510 12/31/2999 12/31/2999J3590 59730420201 12/31/2999 12/31/2999J3590 59730420301 12/31/2999 12/31/2999J3590 59730560101 12/31/2999 1/9/2009J3590 60505070401 12/31/2999 2/3/2006J3590 60505070402 12/31/2999 2/3/2006J3590 60505071700 12/31/2999 10/1/2011J3590 60505071701 12/31/2999 7/3/2006J3590 60505071702 12/31/2999 8/1/2008J3590 60505071703 12/31/2999 8/1/2008J3590 60977014402 6/30/2013 5/4/2012J3590 60977014463 6/30/2013 5/4/2012J3590 60977015501 3/31/2014 10/19/2012J3590 60977015502 3/31/2014 10/19/2012J3590 60977015503 1/31/2014 7/25/2012J3590 60977015504 12/31/2999 2/22/2006J3590 60977015506 10/31/2013 7/25/2012J3590 60977015554 1/31/2014 7/25/2012J3590 61553019341 12/31/2999 12/31/2999J3590 61553024337 12/31/2999 12/31/2999J3590 61553024802 12/31/2999 12/31/2999J3590 61703021309 12/31/2999 5/24/2002J3590 61703021311 12/31/2999 5/24/2002J3590 61703021321 12/31/2999 5/24/2002J3590 61703023322 12/31/2999 8/1/2006J3590 61703023341 12/31/2999 8/1/2006J3590 61958090101 12/31/2999 12/31/2999J3590 62856038901 12/31/2999 12/31/2999J3590 63323002605 12/31/2999 12/31/2999J3590 63323003250 12/31/2999 12/31/2007J3590 63323003261 12/31/2999 12/31/2999J3590 63323006620 12/31/2999 12/31/2007J3590 63323006650 12/31/2999 12/31/2007

Page 135: *This document is a compilation of NDC:HCPCS combinations

J3590 63323006661 12/31/2999 12/31/2007J3590 63323011410 12/31/2999 12/31/2007J3590 63323013011 12/31/2999 12/31/2999J3590 63323013013 12/31/2999 12/31/2999J3590 63323018410 12/31/2999 12/31/2999J3590 63323018411 12/31/2999 12/31/2999J3590 63323020102 12/31/2999 12/31/2999J3590 63323020110 12/31/2999 12/31/2999J3590 63323020202 12/31/2999 12/31/2999J3590 63323020805 12/31/2999 12/31/2999J3590 63323026920 12/31/2999 3/7/2013J3590 63323026927 12/31/2999 12/31/2999J3590 63323026929 12/31/2999 12/31/2999J3590 63323026937 12/31/2999 12/31/2999J3590 63323026950 12/31/2999 12/31/2999J3590 63323026957 12/31/2999 12/31/2999J3590 63323026959 12/31/2999 12/31/2999J3590 63323026965 12/31/2999 12/31/2999J3590 63323026967 12/31/2999 12/31/2999J3590 63323026969 12/31/2999 12/31/2999J3590 63323026994 12/31/2999 12/31/2999J3590 63323027025 12/31/2999 12/31/2999J3590 63323027026 12/31/2999 12/31/2999J3590 63323027027 1/30/2013 6/8/2011J3590 63323027050 12/31/2999 12/31/2999J3590 63323027057 12/31/2999 12/31/2999J3590 63323027065 12/31/2999 12/31/2999J3590 63323027067 12/31/2999 12/31/2999J3590 63323028202 12/31/2999 12/31/2999J3590 63323028204 12/31/2999 12/31/2999J3590 63323028206 12/31/2999 12/31/2999J3590 63323028260 12/31/2999 12/31/2999J3590 63323029730 12/31/2999 12/31/2999J3590 63323029731 12/31/2999 2/1/2013J3590 63323029750 12/31/2999 12/31/2999J3590 63323029751 12/31/2999 2/1/2013J3590 63323029753 12/31/2999 2/1/2013J3590 63323029766 12/31/2999 12/31/2999J3590 63323030201 12/31/2999 12/31/2999J3590 63323032930 12/31/2999 12/31/2999J3590 63323040120 12/31/2999 12/31/2999J3590 63323040220 12/31/2999 12/31/2999J3590 63323042405 12/31/2999 12/31/2999J3590 63323042410 12/31/2999 12/31/2999J3590 63323046410 4/30/2015 11/8/2011J3590 63323046417 12/31/2999 12/31/2999J3590 63323046430 9/30/2014 1/21/2011

Page 136: *This document is a compilation of NDC:HCPCS combinations

J3590 63323046431 12/31/2999 12/31/2999J3590 63323046433 12/31/2999 12/31/2999J3590 63323046437 12/31/2999 12/31/2999J3590 63323046550 3/30/2015 9/8/2011J3590 63323046557 12/31/2999 12/31/2999J3590 63323046610 5/30/2014 5/18/2011J3590 63323046617 12/31/2999 12/31/2999J3590 63323046630 12/30/2013 2/4/2011J3590 63323046631 12/31/2999 12/31/2999J3590 63323046633 12/31/2999 12/31/2999J3590 63323046637 12/31/2999 12/31/2999J3590 63323046750 3/30/2015 6/24/2011J3590 63323046757 12/31/2999 12/31/2999J3590 63323047210 12/31/2999 2/13/2012J3590 63323047217 12/31/2999 12/31/2999J3590 63323047230 6/30/2013 3/2/2011J3590 63323047233 12/31/2999 12/31/2999J3590 63323047237 12/31/2999 12/31/2999J3590 63323048520 10/30/2014 4/26/2011J3590 63323048550 3/30/2015 9/27/2011J3590 63323048610 5/30/2014 9/21/2011J3590 63323048620 12/30/2014 9/8/2011J3590 63323049089 12/31/2999 12/31/2999J3590 63323049150 11/30/2013 1/6/2011J3590 63323049202 4/30/2015 8/2/2011J3590 63323049205 3/30/2014 1/20/2011J3590 63323049230 6/30/2014 1/21/2011J3590 63323049231 12/31/2999 12/31/2999J3590 63323049280 12/31/2999 12/31/2999J3590 63323049289 12/31/2999 12/31/2999J3590 63323049297 12/31/2999 12/31/2999J3590 63323049391 12/31/2999 12/31/2999J3590 63323049397 12/31/2999 12/31/2999J3590 63323049405 12/31/2999 12/31/2999J3590 63323049502 12/30/2014 11/30/2010J3590 63323049505 1/30/2015 4/1/2011J3590 63323049680 12/31/2999 12/31/2999J3590 63323049697 12/31/2999 12/31/2999J3590 63323049889 12/31/2999 12/31/2999J3590 63323065210 12/31/2999 12/31/2999J3590 63323066005 12/31/2999 12/31/2999J3590 63323073804 12/31/2999 11/13/2012J3590 63323073809 12/31/2999 12/31/2999J3590 63323073820 12/31/2999 12/31/2999J3590 63323073912 12/31/2999 12/31/2999J3590 63459039120 12/31/2999 12/31/2999J3590 63833082502 12/31/2999 12/31/2999

Page 137: *This document is a compilation of NDC:HCPCS combinations

J3590 64208823401 12/31/2999 12/31/2999J3590 64208823402 12/31/2999 12/31/2999J3590 64208823403 12/31/2999 12/31/2999J3590 65293000200 12/31/2999 10/3/2011J3590 65293000211 5/31/2012 10/3/2011J3590 65293000250 12/31/2999 10/3/2011J3590 65293000255 5/31/2012 10/3/2011J3590 65293000500 12/31/2999 12/31/2999J3590 65293000511 12/31/2999 12/31/2999J3590 65293000550 12/31/2999 12/31/2999J3590 65293000555 12/31/2999 12/31/2999J3590 65483035502 12/31/2999 2/10/2009J3590 65483035504 12/31/2999 2/10/2009J3590 66302020601 12/31/2999 12/31/2999J3590 66302020602 12/31/2999 12/31/2999J3590 66302020603 12/31/2999 12/31/2999J3590 66479002539 12/31/2999 5/13/2005J3590 66658023407 12/31/2999 12/31/2999J3590 66658023428 12/31/2999 12/31/2999J3590 66860012002 12/31/2999 12/31/2999J3590 66887000301 12/31/2999 12/31/2999J3590 67457000110 12/31/2999 12/31/2999J3590 67457010810 12/31/2999 12/31/2999J3590 67457011850 12/31/2999 12/31/2999J3590 67457018120 12/31/2999 12/31/2999J3590 67457018210 12/31/2999 12/31/2999J3590 67457018320 12/31/2999 12/31/2999J3590 67457018750 12/31/2999 12/31/2999J3590 67457019015 12/31/2999 12/31/2999J3590 67457019115 12/31/2999 9/1/2011J3590 67457019205 12/31/2999 12/31/2999J3590 67467018101 2/12/2013 12/31/2999J3590 67467018102 9/15/2013 12/31/2999J3590 76075010101 12/31/2999 12/31/2999J3590 76125090001 12/31/2999 12/31/2999J3590 76125090010 12/31/2999 12/31/2999J3590 76125090020 12/31/2999 12/31/2999J3590 76125090025 12/31/2999 12/31/2999J3590 76125090050 12/31/2999 12/31/2999J7030 00264400055 6/30/2015 12/31/2999J7030 00264400155 9/30/2015 12/31/2999J7030 00264400255 11/30/2013 12/31/2999J7030 00264780000 12/31/2999 12/31/2999J7030 00264780010 12/31/2999 12/31/2999J7030 00264780020 12/31/2999 12/31/2999J7030 00338004902 12/31/2999 12/31/2999J7030 00338004903 12/31/2999 12/31/2999

Page 138: *This document is a compilation of NDC:HCPCS combinations

J7030 00338004904 12/31/2999 12/31/2999J7030 00338055311 12/31/2999 12/31/2999J7030 00338055318 12/31/2999 12/31/2999J7030 00338630402 12/31/2999 12/31/2999J7030 00338630403 12/31/2999 12/31/2999J7030 00338630404 12/31/2999 12/31/2999J7030 00409158603 12/31/2999 12/31/2999J7030 00409710102 12/31/2999 12/31/2999J7030 00409798302 12/31/2999 12/31/2999J7030 00409798303 12/31/2999 12/31/2999J7030 00409798309 12/31/2999 12/31/2999J7030 00409798325 12/31/2999 12/31/2999J7030 00409798330 12/31/2999 12/31/2999J7030 00409798348 12/31/2999 12/31/2999J7030 00409798353 12/31/2999 12/31/2999J7030 00409798355 12/31/2999 12/31/2999J7030 00409798406 12/31/2999 12/31/2999J7030 00409798411 12/31/2999 12/31/2999J7030 00409798437 12/31/2999 12/31/2999J7030 54868071000 12/31/2999 3/31/2011J7030 54868071006 12/31/2999 5/30/2012J7040 00264400055 6/30/2015 12/31/2999J7040 00264400155 9/30/2015 12/31/2999J7040 00264400255 11/30/2013 12/31/2999J7040 00264780000 12/31/2999 12/31/2999J7040 00264780010 12/31/2999 12/31/2999J7040 00264780020 12/31/2999 12/31/2999J7040 00338004902 12/31/2999 12/31/2999J7040 00338004903 12/31/2999 12/31/2999J7040 00338004904 12/31/2999 12/31/2999J7040 00338630402 12/31/2999 12/31/2999J7040 00338630403 12/31/2999 12/31/2999J7040 00338630404 12/31/2999 12/31/2999J7040 00409158603 12/31/2999 12/31/2999J7040 00409710102 12/31/2999 12/31/2999J7040 00409798302 12/31/2999 12/31/2999J7040 00409798303 12/31/2999 12/31/2999J7040 00409798309 12/31/2999 12/31/2999J7040 00409798325 12/31/2999 12/31/2999J7040 00409798330 12/31/2999 12/31/2999J7040 00409798348 12/31/2999 12/31/2999J7040 00409798353 12/31/2999 12/31/2999J7040 00409798355 12/31/2999 12/31/2999J7040 00409798406 12/31/2999 12/31/2999J7040 00409798411 12/31/2999 12/31/2999J7040 54868071001 12/31/2999 3/31/2011J7040 54868071006 12/31/2999 5/30/2012

Page 139: *This document is a compilation of NDC:HCPCS combinations

J7042 00264760500 12/31/2999 12/31/2999J7042 00264760510 12/31/2999 12/31/2999J7042 00264761000 12/31/2999 12/31/2999J7042 00264761010 12/31/2999 12/31/2999J7042 00264761020 12/31/2999 12/31/2999J7042 00264761200 12/31/2999 12/31/2999J7042 00264761210 12/31/2999 12/31/2999J7042 00264761220 12/31/2999 12/31/2999J7042 00264761400 12/31/2999 12/31/2999J7042 00264761410 12/31/2999 12/31/2999J7042 00264761600 12/31/2999 12/31/2999J7042 00264761610 12/31/2999 12/31/2999J7042 00264761620 12/31/2999 12/31/2999J7042 00264762200 12/31/2999 12/31/2999J7042 00264762320 12/31/2999 12/31/2999J7042 00338007304 12/31/2999 12/31/2999J7042 00338007702 12/31/2999 12/31/2999J7042 00338007703 12/31/2999 12/31/2999J7042 00338007704 12/31/2999 12/31/2999J7042 00338008103 12/31/2999 12/31/2999J7042 00338008302 12/31/2999 12/1/1984J7042 00338008502 12/31/2999 12/31/2999J7042 00338008503 12/31/2999 12/31/2999J7042 00338008504 12/31/2999 12/31/2999J7042 00338008903 12/31/2999 12/31/2999J7042 00338008904 12/31/2999 12/31/2999J7042 00338630803 12/31/2999 12/31/2999J7042 00409486202 12/31/2999 12/31/2999J7042 00409710067 12/31/2999 12/31/2999J7042 00409792402 12/31/2999 12/31/2999J7042 00409792403 12/31/2999 12/31/2999J7042 00409792409 12/31/2999 12/31/2999J7042 00409792503 12/31/2999 12/31/2999J7042 00409792509 12/31/2999 12/31/2999J7042 00409792602 12/31/2999 12/31/2999J7042 00409792603 12/31/2999 12/31/2999J7042 00409792609 12/31/2999 12/31/2999J7042 00409792630 12/31/2999 12/31/2999J7042 00409792648 12/31/2999 12/31/2999J7042 00409794102 12/31/2999 12/31/2999J7042 00409794103 12/31/2999 12/31/2999J7042 00409794109 12/31/2999 12/31/2999J7050 00074210230 12/31/2999 7/19/2011J7050 00264180031 12/31/2999 12/31/2999J7050 00264180032 12/31/2999 12/31/2999J7050 00264180036 12/31/2999 12/31/2999J7050 00264400055 6/30/2015 12/31/2999

Page 140: *This document is a compilation of NDC:HCPCS combinations

J7050 00264400155 9/30/2015 12/31/2999J7050 00264400255 11/30/2013 12/31/2999J7050 00264780000 12/31/2999 12/31/2999J7050 00264780010 12/31/2999 12/31/2999J7050 00264780020 12/31/2999 12/31/2999J7050 00338004901 12/31/2999 12/31/2999J7050 00338004902 12/31/2999 12/31/2999J7050 00338004903 12/31/2999 12/31/2999J7050 00338004904 12/31/2999 12/31/2999J7050 00338004910 12/31/2999 12/31/2999J7050 00338004911 12/31/2999 12/31/2999J7050 00338004918 12/31/2999 12/31/2999J7050 00338004931 12/31/2999 12/31/2999J7050 00338004938 12/31/2999 12/31/2999J7050 00338004941 12/31/2999 12/31/2999J7050 00338004948 12/31/2999 12/31/2999J7050 00338055311 12/31/2999 12/31/2999J7050 00338055318 12/31/2999 12/31/2999J7050 00338630402 12/31/2999 12/31/2999J7050 00338630403 12/31/2999 12/31/2999J7050 00338630404 12/31/2999 12/31/2999J7050 00409158301 12/31/2999 12/31/2999J7050 00409158603 12/31/2999 12/31/2999J7050 00409710102 12/31/2999 12/31/2999J7050 00409710166 12/31/2999 12/31/2999J7050 00409710167 12/31/2999 12/31/2999J7050 00409798302 12/31/2999 12/31/2999J7050 00409798303 12/31/2999 12/31/2999J7050 00409798309 12/31/2999 12/31/2999J7050 00409798325 12/31/2999 12/31/2999J7050 00409798330 12/31/2999 12/31/2999J7050 00409798348 12/31/2999 12/31/2999J7050 00409798353 12/31/2999 12/31/2999J7050 00409798355 12/31/2999 12/31/2999J7050 00409798361 12/31/2999 12/31/2999J7050 00409798406 12/31/2999 12/31/2999J7050 00409798411 12/31/2999 12/31/2999J7050 00409798413 12/31/2999 12/31/2999J7050 00409798420 12/31/2999 12/31/2999J7050 00409798423 12/31/2999 12/31/2999J7050 00409798436 12/31/2999 12/31/2999J7050 00409798437 12/31/2999 12/31/2999J7050 54868071006 12/31/2999 5/30/2012J7050 63323018600 12/31/2999 12/31/2999J7060 00074149501 12/31/2999 5/2/2011J7060 00074710013 12/31/2999 7/19/2011J7060 00264110155 12/31/2014 12/31/2999

Page 141: *This document is a compilation of NDC:HCPCS combinations

J7060 00264110255 12/31/2013 12/31/2999J7060 00264151031 12/31/2999 12/31/2999J7060 00264151032 12/31/2999 12/31/2999J7060 00264151036 12/31/2999 12/31/2999J7060 00264751000 12/31/2999 12/31/2999J7060 00264751010 12/31/2999 12/31/2999J7060 00264751020 12/31/2999 12/31/2999J7060 00338001701 12/31/2999 12/31/2999J7060 00338001702 12/31/2999 12/31/2999J7060 00338001703 12/31/2999 12/31/2999J7060 00338001704 12/31/2999 12/31/2999J7060 00338001710 12/31/2999 12/31/2999J7060 00338001711 12/31/2999 12/31/2999J7060 00338001718 12/31/2999 12/31/2999J7060 00338001731 12/31/2999 12/31/2999J7060 00338001738 12/31/2999 12/31/2999J7060 00338001741 12/31/2999 12/31/2999J7060 00338001748 12/31/2999 12/31/2999J7060 00338055111 12/31/2999 12/31/2999J7060 00338055118 12/31/2999 12/31/2999J7060 00338634602 12/31/2999 12/31/2999J7060 00338634603 12/31/2999 12/31/2999J7060 00409108051 12/31/2999 12/31/2999J7060 00409108251 12/31/2999 12/31/2999J7060 00409152202 12/31/2999 12/31/2999J7060 00409152203 12/31/2999 12/31/2999J7060 00409152301 12/31/2999 12/31/2999J7060 00409710002 12/31/2999 12/31/2999J7060 00409710066 12/31/2999 12/31/2999J7060 00409710067 12/31/2999 12/31/2999J7060 00409792202 12/31/2999 12/31/2999J7060 00409792203 12/31/2999 12/31/2999J7060 00409792209 12/31/2999 12/31/2999J7060 00409792225 12/31/2999 12/31/2999J7060 00409792230 12/31/2999 12/31/2999J7060 00409792248 12/31/2999 12/31/2999J7060 00409792253 12/31/2999 12/31/2999J7060 00409792255 12/31/2999 12/31/2999J7060 00409792261 12/31/2999 12/31/2999J7060 00409792306 12/31/2999 12/31/2999J7060 00409792311 12/31/2999 12/31/2999J7060 00409792313 12/31/2999 12/31/2999J7060 00409792320 12/31/2999 12/31/2999J7060 00409792323 12/31/2999 12/31/2999J7060 00409792336 12/31/2999 12/31/2999J7060 00409792337 12/31/2999 12/31/2999J7060 54868029601 12/31/2999 6/30/2012

Page 142: *This document is a compilation of NDC:HCPCS combinations

J7070 00074710013 12/31/2999 7/19/2011J7070 00264110155 12/31/2014 12/31/2999J7070 00264110255 12/31/2013 12/31/2999J7070 00264151031 12/31/2999 12/31/2999J7070 00264151032 12/31/2999 12/31/2999J7070 00264151036 12/31/2999 12/31/2999J7070 00264751000 12/31/2999 12/31/2999J7070 00264751010 12/31/2999 12/31/2999J7070 00264751020 12/31/2999 12/31/2999J7070 00338001701 12/31/2999 12/31/2999J7070 00338001702 12/31/2999 12/31/2999J7070 00338001703 12/31/2999 12/31/2999J7070 00338001704 12/31/2999 12/31/2999J7070 00338001710 12/31/2999 12/31/2999J7070 00338001711 12/31/2999 12/31/2999J7070 00338001718 12/31/2999 12/31/2999J7070 00338001731 12/31/2999 12/31/2999J7070 00338001738 12/31/2999 12/31/2999J7070 00338001741 12/31/2999 12/31/2999J7070 00338001748 12/31/2999 12/31/2999J7070 00338634602 12/31/2999 12/31/2999J7070 00338634603 12/31/2999 12/31/2999J7070 00409152202 12/31/2999 12/31/2999J7070 00409152203 12/31/2999 12/31/2999J7070 00409152301 12/31/2999 12/31/2999J7070 00409710002 12/31/2999 12/31/2999J7070 00409710066 12/31/2999 12/31/2999J7070 00409792202 12/31/2999 12/31/2999J7070 00409792203 12/31/2999 12/31/2999J7070 00409792209 12/31/2999 12/31/2999J7070 00409792225 12/31/2999 12/31/2999J7070 00409792230 12/31/2999 12/31/2999J7070 00409792248 12/31/2999 12/31/2999J7070 00409792253 12/31/2999 12/31/2999J7070 00409792255 12/31/2999 12/31/2999J7070 00409792261 12/31/2999 12/31/2999J7070 00409792306 12/31/2999 12/31/2999J7070 00409792311 12/31/2999 12/31/2999J7070 00409792313 12/31/2999 12/31/2999J7070 00409792320 12/31/2999 12/31/2999J7070 00409792323 12/31/2999 12/31/2999J7070 00409792336 12/31/2999 12/31/2999J7070 00409792337 12/31/2999 12/31/2999J7070 54868029601 12/31/2999 6/30/2012J7100 00409741803 12/31/2999 12/31/2999J7100 00409741903 12/31/2999 12/31/2999J7110 00409150503 12/31/2999 10/1/2007

Page 143: *This document is a compilation of NDC:HCPCS combinations

J7120 00264775000 12/31/2999 12/31/2999J7120 00264775010 12/31/2999 12/31/2999J7120 00264775020 12/31/2999 12/31/2999J7120 00264775100 12/31/2999 12/31/2999J7120 00264775110 12/31/2999 12/31/2999J7120 00338011702 12/31/2999 12/31/2999J7120 00338011703 12/31/2999 12/31/2999J7120 00338011704 12/31/2999 12/31/2999J7120 00338012503 12/31/2999 12/31/2999J7120 00338012504 12/31/2999 12/31/2999J7120 00338081104 12/31/2999 12/31/2999J7120 00338630702 12/31/2999 12/31/2999J7120 00338630703 12/31/2999 12/31/2999J7120 00338630704 12/31/2999 12/31/2999J7120 00409711109 12/31/2999 12/31/2999J7120 00409711309 12/31/2999 12/31/2999J7120 00409792903 12/31/2999 12/31/2999J7120 00409792909 12/31/2999 12/31/2999J7120 00409795302 12/31/2999 12/31/2999J7120 00409795303 12/31/2999 12/31/2999J7120 00409795309 12/31/2999 12/31/2999J7120 00409795330 12/31/2999 12/31/2999J7120 00409795348 12/31/2999 12/31/2999J7120 54868010200 12/31/2999 6/30/2011J7178 63833089151 12/31/2999 12/31/2999J7178 63833891501 12/31/2999 10/24/2011J7183 67467018101 2/12/2013 12/31/2999J7183 67467018102 9/15/2013 12/31/2999J7183 67467018201 12/31/2999 12/31/2999J7183 67467018202 12/31/2999 12/31/2999J7185 58394001201 12/31/2999 12/31/2999J7185 58394001301 12/31/2999 12/31/2999J7185 58394001401 12/31/2999 12/31/2999J7185 58394001501 12/31/2999 12/31/2999J7185 58394001603 12/31/2999 12/31/2999J7185 58394002203 12/31/2999 12/31/2999J7185 58394002303 12/31/2999 12/31/2999J7185 58394002403 12/31/2999 12/31/2999J7185 58394002503 12/31/2999 12/31/2999J7186 68516460101 12/31/2999 12/31/2999J7186 68516460201 12/31/2999 12/31/2999J7186 68516460302 12/31/2999 12/31/2999J7186 68516460402 12/31/2999 12/31/2999J7187 63833061502 12/31/2999 12/31/2999J7187 63833061602 12/31/2999 12/31/2999J7187 63833061702 12/31/2999 12/31/2999J7189 00169701001 12/31/2999 6/1/2013

Page 144: *This document is a compilation of NDC:HCPCS combinations

J7189 00169702001 12/31/2999 6/1/2013J7189 00169704001 12/31/2999 6/1/2013J7189 00169705001 12/31/2999 6/1/2013J7189 00169720101 12/31/2999 12/31/2999J7189 00169720201 12/31/2999 12/31/2999J7189 00169720501 12/31/2999 12/31/2999J7189 00169720801 12/31/2999 12/31/2999J7190 00053763302 12/31/2999 12/31/2999J7190 00053763402 12/31/2999 12/31/2999J7190 00053765601 12/31/2999 12/31/2999J7190 00053765602 12/31/2999 12/31/2999J7190 00944130110 12/31/2999 9/30/2008J7190 00944130210 12/31/2999 9/30/2008J7190 00944130310 12/31/2999 9/30/2008J7190 00944130410 12/31/2999 9/30/2008J7190 00944293001 12/31/2999 12/31/2999J7190 00944293101 12/31/2999 12/31/2999J7190 00944293201 12/31/2999 12/31/2999J7190 00944293301 12/31/2999 12/31/2999J7190 00944293501 12/31/2999 7/1/2008J7190 00944394002 12/31/2999 12/31/2999J7190 00944394202 12/31/2999 12/31/2999J7190 00944394402 12/31/2999 12/31/2999J7190 00944394602 12/31/2999 12/31/2999J7190 13533066550 3/31/2013 12/31/2012J7190 58394001201 12/31/2999 12/31/2999J7190 58394001301 12/31/2999 12/31/2999J7190 58394001401 12/31/2999 12/31/2999J7190 68516460001 12/31/2999 5/14/2009J7190 68516460002 12/31/2999 5/29/2009J7190 68516460101 12/31/2999 12/31/2999J7190 68516460201 12/31/2999 12/31/2999J7190 68516460302 12/31/2999 12/31/2999J7190 68516460402 12/31/2999 12/31/2999J7190 76125025020 12/31/2999 12/31/2999J7190 76125050030 12/31/2999 12/31/2999J7190 76125066730 12/31/2999 12/31/2999J7190 76125066750 12/31/2999 12/31/2999J7192 00026378220 12/31/2999 12/31/2999J7192 00026378225 12/31/2999 12/31/2999J7192 00026378330 12/31/2999 12/31/2999J7192 00026378335 12/31/2999 12/31/2999J7192 00026378550 12/31/2999 12/31/2999J7192 00026378555 12/31/2999 12/31/2999J7192 00026378660 12/31/2999 12/31/2999J7192 00026378665 12/31/2999 12/31/2999J7192 00026378770 12/31/2999 12/31/2999

Page 145: *This document is a compilation of NDC:HCPCS combinations

J7192 00026378775 12/31/2999 12/31/2999J7192 00026379220 12/31/2999 12/31/2999J7192 00026379330 12/31/2999 12/31/2999J7192 00026379550 12/31/2999 12/31/2999J7192 00026379660 12/31/2999 12/31/2999J7192 00026379770 12/31/2999 12/31/2999J7192 00053813102 12/31/2999 12/31/2999J7192 00053813202 12/31/2999 12/31/2999J7192 00053813302 12/31/2999 12/31/2999J7192 00053813402 12/31/2999 12/31/2999J7192 00053813502 12/31/2999 12/31/2999J7192 00944283210 4/26/2013 12/31/2999J7192 00944283310 4/26/2013 12/31/2999J7192 00944283410 6/2/2013 12/31/2999J7192 00944284110 12/31/2999 12/31/2999J7192 00944284210 12/31/2999 12/31/2999J7192 00944284310 12/31/2999 12/31/2999J7192 00944284410 12/31/2999 12/31/2999J7192 00944284510 12/31/2999 12/31/2999J7192 00944292102 12/31/2999 12/31/2999J7192 00944292202 12/31/2999 12/31/2999J7192 00944292302 12/31/2999 12/31/2999J7192 00944292402 12/31/2999 12/31/2999J7192 00944293801 12/31/2999 10/5/2007J7192 00944293802 12/31/2999 10/5/2007J7192 00944293803 12/31/2999 10/5/2007J7192 00944294002 12/31/2999 1/22/2007J7192 00944294003 12/31/2999 1/22/2007J7192 00944294004 12/31/2999 1/22/2007J7192 00944294010 12/31/2999 1/22/2007J7192 00944294110 12/31/2999 12/31/2999J7192 00944294210 12/31/2999 12/31/2999J7192 00944294310 12/31/2999 12/31/2999J7192 00944294410 12/31/2999 12/31/2999J7192 00944294510 12/31/2999 12/31/2999J7192 00944294610 12/31/2999 12/31/2999J7192 00944294810 12/31/2999 12/31/2999J7192 00944296010 8/31/2012 12/31/2999J7192 00944296110 8/31/2012 12/31/2999J7192 00944296210 8/31/2012 12/31/2999J7192 00944296310 8/31/2012 12/31/2999J7192 00944296410 12/31/2999 12/31/2999J7192 00944296510 12/31/2999 12/31/2999J7192 58394001501 12/31/2999 12/31/2999J7193 00053623302 12/31/2999 12/31/2999J7193 00053766804 1/7/2013 1/7/2013J7193 68516360102 12/31/2999 12/31/2999

Page 146: *This document is a compilation of NDC:HCPCS combinations

J7193 68516360202 12/31/2999 12/31/2999J7193 68516360302 12/31/2999 12/31/2999J7194 64193044502 12/31/2999 12/31/2999J7194 68516320101 12/31/2999 12/31/2999J7194 68516320202 12/31/2999 12/31/2999J7194 68516320302 12/31/2999 12/31/2999J7195 58394000105 12/31/2999 10/17/2011J7195 58394000106 12/31/2013 10/17/2011J7195 58394000205 12/31/2999 8/1/2011J7195 58394000206 12/31/2013 8/1/2011J7195 58394000305 12/31/2999 1/1/2011J7195 58394000306 4/30/2013 1/1/2011J7195 58394000802 12/31/2013 1/1/2011J7195 58394000803 12/31/2999 1/1/2011J7195 58394063303 12/31/2999 12/31/2999J7195 58394063403 12/31/2999 12/31/2999J7195 58394063503 12/31/2999 12/31/2999J7195 58394063603 12/31/2999 12/31/2999J7195 58394063703 12/31/2999 12/31/2999J7197 13533060320 12/31/2999 12/31/2999J7197 13533060330 12/31/2999 1/1/2013J7198 64193022203 12/31/2999 12/31/2999J7198 64193022204 12/31/2999 12/31/2999J7198 64193022302 12/31/2999 12/31/2999J7198 64193022402 12/31/2999 12/31/2999J7198 64193022502 12/31/2999 12/31/2999J7198 64193042302 12/31/2999 12/31/2999J7198 64193042402 12/31/2999 12/31/2999J7198 64193042502 12/31/2999 12/31/2999J7300 51285020401 12/31/2999 12/31/2999J7300 51285020402 10/31/2016 4/15/2011J7302 50419042101 12/31/2999 12/31/2999J7303 00052027301 12/31/2999 12/31/2999J7303 00052027303 12/31/2999 12/31/2999J7303 35356041003 12/31/2999 12/31/2999J7303 54868483201 12/31/2999 12/31/2999J7304 50458019201 12/31/2999 12/31/2999J7304 50458019215 12/31/2999 12/31/2999J7304 54569541300 12/31/2999 12/31/2999J7304 54868467000 12/31/2999 2/28/2011J7307 00052027201 12/31/2999 12/31/2999J7307 00052027401 12/31/2999 12/31/2999J7308 67308010101 12/31/2999 12/31/2999J7308 67308010106 12/31/2999 12/31/2999J7309 00299630002 6/30/2013 6/30/2013J7310 24208041201 12/31/2999 12/31/2999J7311 24208041601 12/31/2999 12/31/2999

Page 147: *This document is a compilation of NDC:HCPCS combinations

J7312 00023334807 12/31/2999 12/31/2999J7316 24856000100 12/31/2999 12/31/2999J7323 55566410001 12/31/2999 12/31/2999J7324 59676036001 12/31/2999 12/31/2999J7325 58468009001 12/31/2999 12/31/2999J7325 58468009003 12/31/2999 12/31/2999J7326 85836015153 12/31/2999 12/31/2999J7330 58468102501 12/31/2999 12/31/2999J7330 63861102501 12/31/2999 12/31/2999J7335 49685092801 12/31/2999 12/31/2999J7335 49685092802 12/31/2999 12/31/2999J7500 00054408425 12/31/2999 12/31/2999J7500 00054808425 12/31/2999 12/31/2999J7500 00378100501 12/31/2999 12/31/2999J7500 21695048475 12/31/2999 12/31/2999J7500 23490511009 12/31/2999 12/31/2999J7500 51079062006 12/31/2999 12/31/2999J7500 52959007900 12/31/2999 12/31/2999J7500 54868092101 12/31/2999 6/30/2012J7500 54868092102 12/31/2999 6/30/2012J7500 54868092104 12/31/2999 6/30/2012J7500 54868531000 12/31/2999 12/31/2999J7500 54868531001 12/31/2999 6/30/2011J7500 54868531002 12/31/2999 6/30/2011J7500 54868531003 12/31/2999 12/31/2999J7500 54868531004 12/31/2999 12/31/2999J7500 57866902101 12/31/2999 1/1/2007J7500 60976059755 12/31/2999 3/9/2006J7500 65483059010 12/31/2999 12/31/2999J7500 65649023141 12/31/2999 12/31/2999J7500 65649024141 12/31/2999 12/31/2999J7500 68084022901 12/31/2999 12/31/2999J7500 68084022911 12/31/2999 12/31/2999J7500 68382000301 12/31/2999 12/31/2999J7500 68382000305 12/31/2999 12/31/2999J7500 68462050201 9/30/2014 12/31/2999J7501 55390060020 12/31/2999 12/31/2999J7502 00074646332 12/31/2999 12/31/2999J7502 00074647932 12/31/2999 12/31/2999J7502 00074726950 12/31/2999 12/31/2999J7502 00078011022 12/31/2999 12/31/2999J7502 00078024115 12/31/2999 12/31/2999J7502 00078024815 12/31/2999 12/31/2999J7502 00078027422 12/31/2999 12/31/2999J7502 00172731246 12/31/2999 12/31/2999J7502 00172731320 12/31/2999 12/31/2999J7502 00185093330 12/31/2999 12/31/2999

Page 148: *This document is a compilation of NDC:HCPCS combinations

J7502 00574086610 12/31/2999 12/31/2999J7502 00591222215 12/31/2999 12/31/2999J7502 00591222315 12/31/2999 12/31/2999J7502 00591222455 12/31/2999 12/31/2999J7502 50111088542 12/31/2999 12/23/2008J7502 50111092043 1/24/2012 12/23/2008J7502 54868552200 12/31/2999 12/31/2999J7502 60432014050 2/29/2012 6/30/2011J7502 60505013400 12/31/2999 12/31/2999J7502 60505035401 12/31/2999 12/31/2999J7504 00009722401 12/31/2999 12/31/2999J7504 00009722402 12/31/2999 12/31/2999J7506 00054001720 12/31/2999 12/31/2999J7506 00054001725 12/31/2999 12/31/2999J7506 00054001729 12/31/2999 12/31/2999J7506 00054001820 12/31/2999 12/31/2999J7506 00054001825 12/31/2999 12/31/2999J7506 00054001829 12/31/2999 12/31/2999J7506 00054001920 12/31/2999 12/31/2999J7506 00054001925 12/31/2999 12/31/2999J7506 00054372144 12/31/2999 12/31/2999J7506 00054372250 12/31/2999 12/31/2999J7506 00054372263 12/31/2999 12/31/2999J7506 00054472825 12/31/2999 12/31/2999J7506 00054472831 12/31/2999 12/31/2999J7506 00054474125 12/31/2999 12/31/2999J7506 00054474131 12/31/2999 12/31/2999J7506 00054474225 12/31/2999 12/31/2999J7506 00054872216 12/31/2999 12/31/2999J7506 00054872425 12/31/2999 12/31/2999J7506 00054873925 12/31/2999 12/31/2999J7506 00054874025 12/31/2999 12/31/2999J7506 00143142501 12/31/2999 12/31/2999J7506 00143147301 12/31/2999 12/31/2999J7506 00143147310 12/31/2999 12/31/2999J7506 00143147501 12/31/2999 12/31/2999J7506 00143147510 12/31/2999 12/31/2999J7506 00143147701 12/31/2999 12/31/2999J7506 00143147705 12/31/2999 12/31/2999J7506 00143147710 12/31/2999 12/31/2999J7506 00143974001 12/31/2999 12/31/2999J7506 00143974010 12/31/2999 12/31/2999J7506 00440216512 12/31/2999 12/31/2999J7506 00440216715 12/31/2999 12/31/2999J7506 00440216720 12/31/2999 12/31/2999J7506 00591505201 12/31/2999 12/31/2999J7506 00591505210 12/31/2999 12/31/2999

Page 149: *This document is a compilation of NDC:HCPCS combinations

J7506 00591544201 12/31/2999 12/31/2999J7506 00591544205 12/31/2999 12/31/2999J7506 00591544210 12/31/2999 12/31/2999J7506 00591544301 12/31/2999 12/31/2999J7506 00591544305 12/31/2999 12/31/2999J7506 00591544310 12/31/2999 12/31/2999J7506 00603533215 12/31/2999 8/20/2003J7506 00603533231 12/31/2999 8/20/2003J7506 00603533421 12/31/2999 9/10/2003J7506 00603533432 12/31/2999 9/10/2003J7506 00603533521 12/31/2999 12/31/2999J7506 00603533532 12/31/2999 12/31/2999J7506 00603533621 12/31/2999 12/31/2999J7506 00603533715 12/31/2999 12/31/2999J7506 00603533721 12/31/2999 12/31/2999J7506 00603533731 12/31/2999 12/31/2999J7506 00603533732 12/31/2999 12/31/2999J7506 00603533815 12/31/2999 12/31/2999J7506 00603533821 12/31/2999 12/31/2999J7506 00603533828 12/31/2999 12/31/2999J7506 00603533831 12/31/2999 12/31/2999J7506 00603533832 12/31/2999 12/31/2999J7506 00603533921 12/31/2999 12/31/2999J7506 00603533928 12/31/2999 12/31/2999J7506 00603533932 12/31/2999 12/31/2999J7506 00615053653 12/31/2999 10/31/2003J7506 00615053663 12/31/2999 10/31/2003J7506 00615359353 12/31/2999 10/31/2003J7506 00615359363 12/31/2999 10/31/2003J7506 16590032630 12/31/2999 12/31/2999J7506 16590032660 12/31/2999 12/31/2999J7506 21695030530 12/31/2999 12/31/2999J7506 21695030620 12/31/2999 12/31/2999J7506 21695030621 12/31/2999 12/31/2999J7506 21695030628 12/31/2999 12/31/2999J7506 21695030630 12/31/2999 12/31/2999J7506 21695030639 12/31/2999 12/31/2999J7506 21695030642 12/31/2999 12/31/2999J7506 21695030710 12/31/2999 12/31/2999J7506 21695030712 12/31/2999 12/31/2999J7506 21695030714 12/31/2999 12/31/2999J7506 21695030715 12/31/2999 12/31/2999J7506 21695030718 12/31/2999 12/31/2999J7506 21695030720 12/31/2999 12/31/2999J7506 21695030721 12/31/2999 12/31/2999J7506 21695030730 12/31/2999 12/31/2999J7506 21695058005 12/31/2999 12/31/2999

Page 150: *This document is a compilation of NDC:HCPCS combinations

J7506 21695076548 12/31/2999 12/31/2999J7506 23490615701 12/31/2999 12/31/2999J7506 23490615702 12/31/2999 12/31/2999J7506 23490615703 12/31/2999 12/31/2999J7506 23490615704 12/31/2999 12/31/2999J7506 23490615705 12/31/2999 12/31/2999J7506 23490615706 12/31/2999 12/31/2999J7506 23490615707 12/31/2999 12/31/2999J7506 23490615708 12/31/2999 12/31/2999J7506 23490615800 12/31/2999 12/31/2999J7506 23490615801 12/31/2999 12/31/2999J7506 23490615802 12/31/2999 12/31/2999J7506 23490615803 12/31/2999 12/31/2999J7506 23490615804 12/31/2999 12/31/2999J7506 23490615805 12/31/2999 12/31/2999J7506 23490615807 12/31/2999 12/31/2999J7506 23490615808 12/31/2999 12/31/2999J7506 23490615809 12/31/2999 12/31/2999J7506 23490615901 12/31/2999 12/31/2999J7506 23490615902 12/31/2999 12/31/2999J7506 23490615903 12/31/2999 12/31/2999J7506 23490615904 12/31/2999 12/31/2999J7506 23490615905 12/31/2999 12/31/2999J7506 23490615906 12/31/2999 12/31/2999J7506 23490785400 12/31/2999 12/31/2999J7506 33358029212 12/31/2999 12/31/2999J7506 33358029215 12/31/2999 12/31/2999J7506 33358029221 12/31/2999 12/31/2999J7506 33358029230 12/31/2999 12/31/2999J7506 33358029278 12/31/2999 12/31/2999J7506 33358029320 12/31/2999 12/31/2999J7506 33358029330 12/31/2999 12/31/2999J7506 33358029340 12/31/2999 12/31/2999J7506 33358029415 12/31/2999 12/31/2999J7506 33358029420 12/31/2999 12/31/2999J7506 33358029430 12/31/2999 12/31/2999J7506 33358029440 12/31/2999 12/31/2999J7506 33358029460 12/31/2999 12/31/2999J7506 42549064714 12/31/2999 12/31/2999J7506 43063009706 12/31/2999 12/31/2999J7506 43063010910 12/31/2999 12/31/2999J7506 45802030321 12/31/2999 4/16/2013J7506 45802030367 12/31/2999 4/16/2013J7506 45802073321 12/31/2999 4/16/2013J7506 45802073367 12/31/2999 4/16/2013J7506 49999000800 12/31/2999 12/31/2999J7506 49999000805 12/31/2999 12/31/2999

Page 151: *This document is a compilation of NDC:HCPCS combinations

J7506 49999000820 12/31/2999 12/31/2999J7506 49999000830 12/31/2999 12/31/2999J7506 49999000840 12/31/2999 12/31/2999J7506 49999000842 12/31/2999 12/31/2999J7506 49999000855 12/31/2999 12/31/2999J7506 49999002805 12/31/2999 12/31/2999J7506 49999002812 12/31/2999 12/31/2999J7506 49999002814 12/31/2999 12/31/2999J7506 49999002815 12/31/2999 12/31/2999J7506 49999002820 12/31/2999 12/31/2999J7506 49999002821 12/31/2999 12/31/2999J7506 49999002828 12/31/2999 12/31/2999J7506 49999002830 12/31/2999 12/31/2999J7506 49999002840 12/31/2999 12/31/2999J7506 49999002848 12/31/2999 12/31/2999J7506 49999002850 12/31/2999 12/31/2999J7506 49999002860 12/31/2999 12/31/2999J7506 49999002890 12/31/2999 12/31/2999J7506 49999011000 12/31/2999 12/31/2999J7506 49999011006 12/31/2999 12/31/2999J7506 49999011007 12/31/2999 12/31/2999J7506 49999011010 12/31/2999 12/31/2999J7506 49999011012 12/31/2999 12/31/2999J7506 49999011014 12/31/2999 12/31/2999J7506 49999011015 12/31/2999 12/31/2999J7506 49999011018 12/31/2999 12/31/2999J7506 49999011020 12/31/2999 12/31/2999J7506 49999011021 12/31/2999 12/31/2999J7506 49999011030 12/31/2999 12/31/2999J7506 49999039021 12/31/2999 10/31/2009J7506 49999043703 12/31/2999 12/31/2999J7506 51655002024 12/31/2999 9/25/2007J7506 51655002052 12/31/2999 9/25/2007J7506 51655002053 12/31/2999 9/25/2007J7506 51655008624 12/31/2999 9/25/2007J7506 51655008627 12/31/2999 9/25/2007J7506 51991045801 12/31/2999 12/1/2011J7506 52959012600 12/31/2999 12/31/2999J7506 52959012605 12/31/2999 12/31/2999J7506 52959012607 12/31/2999 12/31/2999J7506 52959012610 12/31/2999 12/31/2999J7506 52959012612 12/31/2999 12/31/2999J7506 52959012615 12/31/2999 12/31/2999J7506 52959012618 12/31/2999 12/31/2999J7506 52959012620 12/31/2999 12/31/2999J7506 52959012621 12/31/2999 12/31/2999J7506 52959012625 12/31/2999 12/31/2999

Page 152: *This document is a compilation of NDC:HCPCS combinations

J7506 52959012630 12/31/2999 12/31/2999J7506 52959012640 12/31/2999 12/31/2999J7506 52959012642 12/31/2999 12/31/2999J7506 52959012644 12/31/2999 12/31/2999J7506 52959012650 12/31/2999 12/31/2999J7506 52959012660 12/31/2999 12/31/2999J7506 52959012670 12/31/2999 12/31/2999J7506 52959012700 12/31/2999 12/31/2999J7506 52959012707 12/31/2999 12/31/2999J7506 52959012710 12/31/2999 12/31/2999J7506 52959012712 12/31/2999 12/31/2999J7506 52959012715 12/31/2999 12/31/2999J7506 52959012718 12/31/2999 12/31/2999J7506 52959012720 12/31/2999 12/31/2999J7506 52959012721 12/31/2999 12/31/2999J7506 52959012725 12/31/2999 12/31/2999J7506 52959012730 12/31/2999 12/31/2999J7506 52959012737 12/31/2999 12/31/2999J7506 52959012742 12/31/2999 12/31/2999J7506 52959022000 12/31/2999 12/31/2999J7506 52959022010 12/31/2999 12/31/2999J7506 52959022020 12/31/2999 12/31/2999J7506 52959022021 12/31/2999 12/31/2999J7506 52959022030 12/31/2999 12/31/2999J7506 52959022036 12/31/2999 12/31/2999J7506 52959022040 12/31/2999 12/31/2999J7506 52959022060 12/31/2999 12/31/2999J7506 52959022075 12/31/2999 12/31/2999J7506 52959095405 12/31/2999 12/31/2999J7506 53489013801 1/31/2012 6/14/2010J7506 53489013810 3/31/2012 5/10/2010J7506 53489013901 4/30/2012 6/15/2010J7506 53489013905 4/30/2012 3/1/2011J7506 53489013910 1/31/2012 5/11/2011J7506 53489014001 4/30/2012 6/14/2010J7506 53489014005 4/30/2012 7/13/2010J7506 53489014010 1/31/2012 5/10/2010J7506 54569033000 12/31/2999 12/31/2999J7506 54569033001 12/31/2999 12/31/2999J7506 54569033002 12/31/2999 1/31/2003J7506 54569033003 12/31/2999 12/31/2999J7506 54569033004 12/31/2999 12/31/2999J7506 54569033005 12/31/2999 1/31/2003J7506 54569033007 12/31/2999 12/31/2999J7506 54569033008 12/31/2999 1/31/2003J7506 54569033009 12/31/2999 6/1/2003J7506 54569033100 12/31/2999 12/31/2999

Page 153: *This document is a compilation of NDC:HCPCS combinations

J7506 54569033101 12/31/2999 12/31/2999J7506 54569033102 12/31/2999 12/31/2999J7506 54569033103 12/31/2999 6/1/2003J7506 54569033104 12/31/2999 12/31/2999J7506 54569033105 12/31/2999 12/31/2999J7506 54569033106 12/31/2999 6/1/2003J7506 54569033107 12/31/2999 12/31/2999J7506 54569033108 12/31/2999 12/31/2999J7506 54569033109 12/31/2999 6/1/2003J7506 54569033200 12/31/2999 6/1/2003J7506 54569033201 12/31/2999 12/31/2999J7506 54569033202 12/31/2999 12/31/2999J7506 54569033203 12/31/2999 12/31/2999J7506 54569033204 12/31/2999 1/31/2003J7506 54569033205 12/31/2999 12/31/2999J7506 54569033208 12/31/2999 6/1/2003J7506 54569033209 12/31/2999 12/31/2999J7506 54569033300 12/31/2999 6/1/2003J7506 54569033304 12/31/2999 6/1/2003J7506 54569278500 12/31/2999 6/1/2003J7506 54569304300 12/31/2999 12/31/2999J7506 54569304301 12/31/2999 12/31/2999J7506 54569304302 12/31/2999 6/1/2003J7506 54569304303 12/31/2999 6/1/2003J7506 54569304304 12/31/2999 7/10/2002J7506 54569304305 12/31/2999 12/31/2999J7506 54569304306 12/31/2999 12/31/2999J7506 54569330200 12/31/2999 12/31/2999J7506 54569330201 12/31/2999 12/31/2999J7506 54569330202 12/31/2999 6/1/2003J7506 54569330205 12/31/2999 6/1/2003J7506 54569330206 12/31/2999 6/1/2003J7506 54569330207 12/31/2999 1/31/2003J7506 54569330208 12/31/2999 6/1/2003J7506 54569330209 12/31/2999 1/31/2003J7506 54569341300 12/31/2999 12/31/2999J7506 54569401700 12/31/2999 1/31/2003J7506 54569402600 12/31/2999 1/31/2003J7506 54569402601 12/31/2999 1/31/2003J7506 54569402604 12/31/2999 12/31/2999J7506 54569402605 12/31/2999 6/1/2003J7506 54569422600 12/31/2999 6/1/2003J7506 54868025800 12/31/2999 4/15/2002J7506 54868025801 12/31/2999 12/31/2999J7506 54868025802 12/31/2999 12/31/2999J7506 54868025803 12/31/2999 9/30/2006J7506 54868025804 12/31/2999 12/31/2999

Page 154: *This document is a compilation of NDC:HCPCS combinations

J7506 54868025805 12/31/2999 12/31/2999J7506 54868025806 12/31/2999 12/31/2999J7506 54868025807 12/31/2999 9/19/2000J7506 54868025808 12/31/2999 12/31/2999J7506 54868025809 12/31/2999 6/30/2012J7506 54868083600 12/31/2999 12/31/2999J7506 54868083602 12/31/2999 12/31/2999J7506 54868083603 12/31/2999 12/31/2999J7506 54868083604 12/31/2999 12/31/2999J7506 54868083605 12/31/2999 12/31/2999J7506 54868083607 12/31/2999 12/31/2999J7506 54868083608 12/31/2999 12/31/2999J7506 54868083609 12/31/2999 4/15/2002J7506 54868090800 12/31/2999 12/31/2999J7506 54868090801 12/31/2999 12/31/2999J7506 54868090802 12/31/2999 6/30/2012J7506 54868090803 12/31/2999 12/31/2999J7506 54868090804 12/31/2999 6/30/2012J7506 54868090805 12/31/2999 12/31/2999J7506 54868111901 12/31/2999 12/31/2999J7506 54868111902 12/31/2999 6/30/2012J7506 54868111903 12/31/2999 12/31/2999J7506 54868111904 12/31/2999 6/30/2012J7506 54868111905 12/31/2999 12/31/2999J7506 54868118300 12/31/2999 12/31/2999J7506 54868118301 12/31/2999 12/31/2999J7506 54868118302 12/31/2999 12/31/2999J7506 54868118303 12/31/2999 12/31/2999J7506 54868118304 12/31/2999 12/31/2999J7506 54868118307 12/31/2999 12/31/2999J7506 54868118308 12/31/2999 12/31/2999J7506 54868118309 12/31/2999 12/31/2999J7506 54868323400 12/31/2999 8/31/2009J7506 54868409500 12/31/2999 12/31/2999J7506 54868409600 12/31/2999 12/31/2999J7506 54868521300 12/31/2999 12/31/2999J7506 54868523000 12/31/2999 12/31/2999J7506 55045126009 12/31/2999 12/31/2999J7506 55045144401 12/31/2999 1/1/2003J7506 55045144403 12/31/2999 10/7/2009J7506 55045144404 12/31/2999 10/7/2009J7506 55045144407 12/31/2999 10/7/2009J7506 55045144408 12/31/2999 10/7/2009J7506 55045148000 12/31/2999 1/1/2003J7506 55045148001 12/31/2999 10/7/2009J7506 55045148002 12/31/2999 1/1/2003J7506 55045148005 12/31/2999 1/1/2003

Page 155: *This document is a compilation of NDC:HCPCS combinations

J7506 55045148006 12/31/2999 1/1/2003J7506 55045148007 12/31/2999 10/7/2009J7506 55045148008 12/31/2999 10/7/2009J7506 55045148009 12/31/2999 10/7/2009J7506 55045153303 12/31/2999 10/7/2009J7506 55045153306 12/31/2999 10/7/2009J7506 55045153307 12/31/2999 10/7/2009J7506 55045153308 12/31/2999 10/7/2009J7506 55045153309 12/31/2999 10/7/2009J7506 55045180902 12/31/2999 1/1/2003J7506 55289033005 12/31/2999 12/31/2999J7506 55289033007 12/31/2999 12/31/2999J7506 55289033010 12/31/2999 12/31/2999J7506 55289035205 12/31/2999 12/31/2999J7506 55289035207 12/31/2999 12/31/2999J7506 55289035209 12/31/2999 12/31/2999J7506 55289035210 12/31/2999 12/31/2999J7506 55289035212 12/31/2999 12/31/2999J7506 55289035214 12/31/2999 12/31/2999J7506 55289035215 12/31/2999 12/31/2999J7506 55289035220 12/31/2999 12/31/2999J7506 55289035221 12/31/2999 12/31/2999J7506 55289035230 12/31/2999 12/31/2999J7506 55289037301 12/31/2999 12/31/2999J7506 55289037330 12/31/2999 12/31/2999J7506 55289037336 12/31/2999 12/31/2999J7506 55289037342 12/31/2999 12/31/2999J7506 55289037346 12/31/2999 12/31/2999J7506 55289037355 12/31/2999 12/31/2999J7506 55289037360 12/31/2999 12/31/2999J7506 55289037372 12/31/2999 12/31/2999J7506 55289043820 12/31/2999 12/31/2999J7506 55289043821 12/31/2999 12/31/2999J7506 55289043830 12/31/2999 12/31/2999J7506 55289043836 12/31/2999 12/31/2999J7506 55289043838 12/31/2999 12/31/2999J7506 55289043840 12/31/2999 12/31/2999J7506 55289043842 12/31/2999 12/31/2999J7506 55289043850 12/31/2999 12/31/2999J7506 55289043860 12/31/2999 12/31/2999J7506 55887064321 12/31/2999 7/25/2008J7506 55887064330 12/31/2999 7/25/2008J7506 55887069621 12/31/2999 7/25/2008J7506 55887077021 12/31/2999 4/1/2007J7506 55887079630 12/31/2999 7/25/2008J7506 58016021600 12/31/2999 11/29/2012J7506 58016021612 12/31/2999 11/29/2012

Page 156: *This document is a compilation of NDC:HCPCS combinations

J7506 58016021614 12/31/2999 11/29/2012J7506 58016021615 12/31/2999 11/29/2012J7506 58016021620 12/31/2999 11/29/2012J7506 58016021621 12/31/2999 11/29/2012J7506 58016021624 12/31/2999 11/29/2012J7506 58016021628 12/31/2999 11/29/2012J7506 58016021630 12/31/2999 11/29/2012J7506 58016021632 12/31/2999 11/29/2012J7506 58016021640 12/31/2999 11/29/2012J7506 58016021650 12/31/2999 11/29/2012J7506 58016021660 12/31/2999 11/29/2012J7506 58016021690 12/31/2999 11/29/2012J7506 58016021700 12/31/2999 11/29/2012J7506 58016021710 12/31/2999 11/29/2012J7506 58016021715 12/31/2999 11/29/2012J7506 58016021716 12/31/2999 11/29/2012J7506 58016021718 12/31/2999 11/29/2012J7506 58016021720 12/31/2999 11/29/2012J7506 58016021721 12/31/2999 11/29/2012J7506 58016021722 12/31/2999 11/29/2012J7506 58016021724 12/31/2999 11/29/2012J7506 58016021728 12/31/2999 11/29/2012J7506 58016021730 12/31/2999 11/29/2012J7506 58016021740 12/31/2999 11/29/2012J7506 58016021760 12/31/2999 11/29/2012J7506 58016021800 12/31/2999 11/29/2012J7506 58016021820 12/31/2999 11/29/2012J7506 58016021821 12/31/2999 11/29/2012J7506 58016021824 12/31/2999 11/29/2012J7506 58016021830 12/31/2999 11/29/2012J7506 58016021833 12/31/2999 11/29/2012J7506 58016021836 12/31/2999 11/29/2012J7506 58016021840 12/31/2999 11/29/2012J7506 58016021850 12/31/2999 11/29/2012J7506 58016021855 12/31/2999 11/29/2012J7506 58016021860 12/31/2999 11/29/2012J7506 58016021890 12/31/2999 11/29/2012J7506 58016483201 12/31/2999 11/29/2012J7506 58864036220 12/31/2999 12/31/2999J7506 58864036256 12/31/2999 12/31/2999J7506 58864042315 12/31/2999 12/31/2999J7506 58864042320 12/31/2999 12/31/2999J7506 58864042330 12/31/2999 12/31/2999J7506 58864042340 12/31/2999 12/31/2999J7506 58864042414 12/31/2999 12/31/2999J7506 58864042420 12/31/2999 12/31/2999J7506 58864042430 12/31/2999 12/31/2999

Page 157: *This document is a compilation of NDC:HCPCS combinations

J7506 59746017106 12/31/2999 12/31/2999J7506 59746017110 12/31/2999 12/31/2999J7506 59746017206 12/31/2999 12/31/2999J7506 59746017210 12/31/2999 12/31/2999J7506 59746017306 12/31/2999 12/31/2999J7506 59746017309 12/31/2999 12/31/2999J7506 59746017310 12/31/2999 12/31/2999J7506 59746017506 12/31/2999 12/31/2999J7506 59746017509 12/31/2999 12/31/2999J7506 59746017510 12/31/2999 12/31/2999J7506 60346005812 12/31/2999 5/9/2001J7506 60346005818 12/31/2999 5/9/2001J7506 60346005820 12/31/2999 5/9/2001J7506 60346005821 12/31/2999 5/9/2001J7506 60346005827 12/31/2999 5/9/2001J7506 60346005830 12/31/2999 5/9/2001J7506 60346005840 12/31/2999 5/9/2001J7506 60346005850 12/31/2999 5/9/2001J7506 60346005854 12/31/2999 5/9/2001J7506 60346005890 12/31/2999 5/9/2001J7506 60346009409 12/31/2999 5/9/2001J7506 60346009410 12/31/2999 5/9/2001J7506 60346009412 12/31/2999 5/9/2001J7506 60346009415 12/31/2999 5/9/2001J7506 60346009418 12/31/2999 5/9/2001J7506 60346009420 12/31/2999 5/9/2001J7506 60346009424 12/31/2999 5/9/2001J7506 60346009430 12/31/2999 5/9/2001J7506 60346009440 12/31/2999 5/9/2001J7506 60346009490 12/31/2999 5/9/2001J7506 60346051512 12/31/2999 5/9/2001J7506 60346051520 12/31/2999 5/9/2001J7506 60346051530 12/31/2999 5/9/2001J7506 60346051536 12/31/2999 5/9/2001J7506 60346051540 12/31/2999 5/9/2001J7506 60346051550 12/31/2999 5/9/2001J7506 60346051560 12/31/2999 5/9/2001J7506 60346051575 12/31/2999 5/9/2001J7506 60346051590 12/31/2999 5/9/2001J7506 60346072140 12/31/2999 5/9/2001J7506 60760000221 12/31/2999 12/31/2999J7506 60760013830 12/31/2999 10/1/2008J7506 60760063028 12/31/2999 1/1/2008J7506 60904028620 12/31/2999 2/12/2007J7506 63629157902 12/31/2999 12/31/2999J7506 63629157903 12/31/2999 12/31/2999J7506 63629158701 12/31/2999 12/31/2999

Page 158: *This document is a compilation of NDC:HCPCS combinations

J7506 63629158702 12/31/2999 12/31/2999J7506 63629158703 12/31/2999 12/31/2999J7506 63629158704 12/31/2999 12/31/2999J7506 63629160501 12/31/2999 12/31/2999J7506 63629160502 12/31/2999 12/31/2999J7506 63739020715 12/31/2999 10/3/2008J7506 63739020815 12/31/2999 10/3/2008J7506 63739020915 12/31/2999 10/3/2008J7506 66116046530 12/31/2999 1/1/2007J7506 66116046550 12/31/2999 1/1/2007J7506 66116062530 12/31/2999 1/1/2007J7506 66267017115 12/31/2999 12/31/2999J7506 66267017120 12/31/2999 12/31/2999J7506 66267017121 12/31/2999 12/31/2999J7506 66267017130 12/31/2999 12/31/2999J7506 66267017140 12/31/2999 12/31/2999J7506 66267017142 12/31/2999 12/31/2999J7506 66267017210 12/31/2999 12/31/2999J7506 66267017215 12/31/2999 12/31/2999J7506 66267017220 12/31/2999 12/31/2999J7506 66267017230 12/31/2999 12/31/2999J7506 66267017242 12/31/2999 12/31/2999J7506 66267017320 12/31/2999 12/31/2999J7506 66267017330 12/31/2999 12/31/2999J7506 66267017340 12/31/2999 12/31/2999J7506 66267017342 12/31/2999 12/31/2999J7506 66267017360 12/31/2999 12/31/2999J7506 66267094821 12/31/2999 12/31/2999J7506 66336005830 12/31/2999 12/31/2999J7506 66336009410 12/31/2999 12/31/2999J7506 66336009418 12/31/2999 12/31/2999J7506 66336009420 12/31/2999 12/31/2999J7506 66336009421 12/31/2999 12/31/2999J7506 67544039960 12/31/2999 12/31/2999J7506 68115028930 12/31/2999 4/1/2009J7506 68115094721 12/31/2999 4/1/2009J7506 68387024010 12/31/2999 12/31/2999J7506 68387024025 12/31/2999 12/31/2999J7506 68387024115 12/31/2999 12/31/2999J7507 00078061605 12/31/2999 12/31/2999J7507 00078061705 12/31/2999 12/31/2999J7507 00078061805 12/31/2999 12/31/2999J7507 00378204501 12/31/2999 12/31/2999J7507 00378204505 12/31/2999 12/31/2999J7507 00378204601 12/31/2999 12/31/2999J7507 00378204605 12/31/2999 12/31/2999J7507 00378204701 12/31/2999 12/31/2999

Page 159: *This document is a compilation of NDC:HCPCS combinations

J7507 00378204705 12/31/2999 12/31/2999J7507 00469060773 12/31/2999 12/31/2999J7507 00469061711 12/31/2999 12/31/2999J7507 00469061773 12/31/2999 12/31/2999J7507 00469065711 12/31/2999 12/31/2999J7507 00469065773 12/31/2999 12/31/2999J7507 00781210201 12/31/2999 12/31/2999J7507 00781210301 12/31/2999 12/31/2999J7507 00781210401 12/31/2999 12/31/2999J7507 00781930201 12/31/2999 12/31/2999J7507 00781930301 12/31/2999 12/31/2999J7507 00781930401 12/31/2999 12/31/2999J7507 16729004101 12/31/2999 12/31/2999J7507 16729004201 12/31/2999 12/31/2999J7507 16729004301 12/31/2999 12/31/2999J7507 21695017000 12/31/2999 12/31/2999J7507 50742020701 12/31/2999 12/31/2999J7507 50742020801 12/31/2999 12/31/2999J7507 50742020901 12/31/2999 12/31/2999J7507 55111052501 12/31/2999 12/31/2999J7507 55111052601 12/31/2999 12/31/2999J7507 55111052701 12/31/2999 12/31/2999J7507 67263039601 12/31/2999 5/1/2011J7507 67544120553 12/31/2999 7/26/2011J7507 67544120560 12/31/2999 7/26/2011J7507 67544120580 12/31/2999 7/26/2011J7507 68084044901 12/31/2999 12/31/2999J7507 68084045001 12/31/2999 12/31/2999J7507 68084045101 12/31/2999 12/31/2999J7508 00469064773 12/31/2999 12/31/2999J7508 00469067773 12/31/2999 12/31/2999J7508 00469068773 12/31/2999 12/31/2999J7509 00009002001 12/31/2999 12/31/2999J7509 00009002201 12/31/2999 12/31/2999J7509 00009004902 12/31/2999 12/31/2999J7509 00009005602 12/31/2999 12/31/2999J7509 00009005604 12/31/2999 12/31/2999J7509 00009007301 12/31/2999 12/31/2999J7509 00009017601 12/31/2999 12/31/2999J7509 00527129607 12/31/2999 12/11/2006J7509 00555030102 2/29/2012 3/14/2011J7509 00555030138 7/31/2012 12/7/2010J7509 00603459315 12/31/2999 12/31/2999J7509 00603459321 12/31/2999 12/31/2999J7509 00781502201 12/31/2999 12/31/2999J7509 00781502207 12/31/2999 12/31/2999J7509 00904217519 12/31/2999 3/1/2010

Page 160: *This document is a compilation of NDC:HCPCS combinations

J7509 16590014921 12/31/2999 12/31/2999J7509 21695008021 12/31/2999 12/31/2999J7509 23490590201 12/31/2999 12/31/2999J7509 33358024121 12/31/2999 12/31/2999J7509 42549052221 12/31/2999 12/31/2999J7509 49999015321 12/31/2999 12/31/2999J7509 51285030102 12/31/2999 1/30/2002J7509 51991018801 12/31/2999 4/1/2009J7509 51991018831 12/31/2999 12/31/2999J7509 52959010000 12/31/2999 12/31/2999J7509 54569032700 12/31/2999 12/31/2999J7509 54569103600 12/31/2999 12/31/2999J7509 54569451600 12/31/2999 7/1/2002J7509 54569458000 12/31/2999 1/31/2003J7509 54868077601 12/31/2999 6/30/2011J7509 54868291300 12/31/2999 6/30/2011J7509 54868291301 12/31/2999 12/31/2999J7509 54868291302 12/31/2999 6/30/2011J7509 54868291303 12/31/2999 3/14/2011J7509 54868495200 12/31/2999 6/30/2011J7509 54868495201 12/31/2999 6/30/2011J7509 54868662401 12/31/2999 12/31/2999J7509 55045125909 12/31/2999 12/31/2999J7509 55045181108 12/31/2999 1/1/2003J7509 55289064930 12/31/2999 12/31/2999J7509 55289064998 12/31/2999 12/31/2999J7509 58016200101 12/31/2999 11/29/2012J7509 58016200401 12/31/2999 11/29/2012J7509 58016471901 12/31/2999 11/29/2012J7509 59746000103 12/31/2999 12/31/2999J7509 59746000106 12/31/2999 12/31/2999J7509 59746000204 12/31/2999 12/31/2999J7509 59746000206 12/31/2999 4/21/2004J7509 59746000314 12/31/2999 12/31/2999J7509 59746001504 12/31/2999 12/31/2999J7509 59762004901 12/31/2999 12/31/2999J7509 59762005001 12/31/2999 12/31/2999J7509 59762005101 12/31/2999 12/31/2999J7509 59762444003 12/31/2999 12/31/2999J7509 60346060810 12/31/2999 5/9/2001J7509 60346060820 12/31/2999 5/9/2001J7509 60346060844 12/31/2999 5/9/2001J7509 66116066221 12/31/2999 1/1/2007J7509 66267096121 12/31/2999 12/31/2999J7509 67263040086 12/31/2999 5/1/2011J7509 68001000501 12/31/2999 12/31/2999J7509 68084014901 12/31/2999 12/31/2999

Page 161: *This document is a compilation of NDC:HCPCS combinations

J7509 68115096021 12/31/2999 4/1/2009J7509 68387017001 12/31/2999 12/31/2999J7510 00093611816 12/31/2999 12/31/2999J7510 00093611887 12/31/2999 12/31/2999J7510 00121075908 12/31/2999 12/31/2999J7510 00143147310 12/31/2999 12/31/2999J7510 00364021701 12/31/2999 11/6/2001J7510 00527120105 12/31/2999 3/15/2002J7510 16477050501 12/31/2999 12/31/2999J7510 16477050521 12/31/2999 12/31/2999J7510 21695036508 12/31/2999 12/31/2999J7510 21695036516 12/31/2999 12/31/2999J7510 21695040508 12/31/2999 12/31/2999J7510 23490614401 12/31/2999 12/31/2999J7510 23490614402 12/31/2999 12/31/2999J7510 23490614403 12/31/2999 12/31/2999J7510 23490614501 12/31/2999 12/31/2999J7510 23490614502 12/31/2999 12/31/2999J7510 23490614503 12/31/2999 12/31/2999J7510 33358029108 12/31/2999 12/31/2999J7510 35356048804 12/31/2999 5/22/2012J7510 38739015008 12/31/2999 12/31/2999J7510 49999033508 12/31/2999 12/31/2999J7510 49999033524 12/31/2999 12/31/2999J7510 49999092901 12/31/2999 12/31/2999J7510 50383004004 12/31/2999 12/31/2999J7510 50383004224 12/31/2999 12/31/2999J7510 50383004248 12/31/2999 12/31/2999J7510 50383017708 12/31/2999 11/12/2008J7510 51672133803 12/31/2999 12/31/2999J7510 52959062260 12/31/2999 12/31/2999J7510 53014025001 12/31/2013 5/18/2012J7510 54569133500 12/31/2999 5/18/2012J7510 54569482700 12/31/2999 12/31/2999J7510 54569482701 12/31/2999 8/16/2011J7510 54569520400 12/31/2999 4/30/2008J7510 54569520401 12/31/2999 4/11/2008J7510 54569574900 12/31/2999 12/31/2999J7510 54868082100 12/31/2999 12/31/2999J7510 54868095400 12/31/2999 6/30/2012J7510 54868172000 12/31/2999 5/21/2012J7510 54868322000 12/31/2999 6/30/2010J7510 54868474800 12/31/2999 6/30/2012J7510 54868474900 12/31/2999 12/31/2999J7510 54868474901 12/31/2999 12/31/2999J7510 54868524200 12/31/2999 12/31/2999J7510 58016414401 12/31/2999 5/21/2012

Page 162: *This document is a compilation of NDC:HCPCS combinations

J7510 58016484301 12/31/2999 11/29/2012J7510 59630070048 12/31/2999 12/31/2999J7510 59630070148 12/31/2999 12/31/2999J7510 59630070248 12/31/2999 12/31/2999J7510 59630071008 12/31/2999 12/31/2999J7510 59630071010 12/31/2999 12/31/2999J7510 60432021208 12/31/2999 12/31/2999J7510 63629186201 12/31/2999 12/31/2999J7510 65162066788 1/31/2013 1/31/2013J7510 65162066790 1/31/2013 1/31/2013J7510 65580025101 3/13/2013 12/31/2999J7511 58468008001 12/31/2999 12/31/2999J7515 00074646332 12/31/2999 12/31/2999J7515 00074647932 12/31/2999 12/31/2999J7515 00078024015 12/31/2999 12/31/2999J7515 00078024115 12/31/2999 12/31/2999J7515 00078024615 12/31/2999 12/31/2999J7515 00078024815 12/31/2999 12/31/2999J7515 00172731046 12/31/2999 12/31/2999J7515 00172731146 12/31/2999 12/31/2999J7515 00172731246 12/31/2999 12/31/2999J7515 00185093230 12/31/2999 12/31/2999J7515 00185093330 12/31/2999 12/31/2999J7515 00591222215 12/31/2999 12/31/2999J7515 00591222315 12/31/2999 12/31/2999J7515 00591222455 12/31/2999 12/31/2999J7515 54868552200 12/31/2999 12/31/2999J7515 60505013300 12/31/2999 12/31/2999J7515 60505013400 12/31/2999 12/31/2999J7515 60505035401 12/31/2999 12/31/2999J7516 00078010901 12/31/2999 12/31/2999J7516 00574086610 12/31/2999 12/31/2999J7516 55390012210 12/31/2999 12/31/2999J7516 60505035401 12/31/2999 12/31/2999J7517 00004025901 12/31/2999 12/31/2999J7517 00004025905 12/31/2999 12/31/2999J7517 00004025943 12/31/2999 12/31/2999J7517 00004026001 12/31/2999 12/31/2999J7517 00004026043 12/31/2999 12/31/2999J7517 00004026129 12/31/2999 12/31/2999J7517 00054016325 12/31/2999 12/31/2999J7517 00054016329 12/31/2999 12/31/2999J7517 00054016625 12/31/2999 12/31/2999J7517 00054016629 12/31/2999 12/31/2999J7517 00093733401 12/31/2999 12/31/2999J7517 00093733405 12/31/2999 12/31/2999J7517 00093733419 2/28/2014 12/11/2012

Page 163: *This document is a compilation of NDC:HCPCS combinations

J7517 00093733493 2/28/2014 12/11/2012J7517 00093747701 12/31/2999 12/31/2999J7517 00093747705 12/31/2999 12/31/2999J7517 00378225001 12/31/2999 12/31/2999J7517 00378225005 12/31/2999 12/31/2999J7517 00378447201 12/31/2999 12/31/2999J7517 00378447205 12/31/2999 12/31/2999J7517 00781206701 12/31/2999 12/31/2999J7517 00781206705 12/31/2999 12/31/2999J7517 00781206789 12/31/2999 12/31/2999J7517 00781517501 12/31/2999 12/31/2999J7517 00781517505 12/31/2999 12/31/2999J7517 16729001901 12/31/2999 12/31/2999J7517 16729001916 12/31/2999 12/31/2999J7517 16729009401 12/31/2999 12/31/2999J7517 16729009416 12/31/2999 12/31/2999J7517 21695017100 12/31/2999 12/31/2999J7517 49999093600 12/31/2999 12/31/2999J7517 49999093630 12/31/2999 12/31/2999J7517 49999093730 12/31/2999 12/31/2999J7517 51079037901 12/31/2999 12/31/2999J7517 51079037920 12/31/2999 12/31/2999J7517 51079072101 12/31/2999 12/31/2999J7517 51079072120 12/31/2999 12/31/2999J7517 59762070201 12/31/2999 12/31/2999J7517 59762070203 12/31/2999 12/31/2999J7517 59762070301 12/31/2999 12/31/2999J7517 59762070302 12/31/2999 12/31/2999J7517 59762070303 12/31/2999 12/31/2999J7517 60505296701 12/31/2999 12/31/2999J7517 60505296705 12/31/2999 12/31/2999J7517 60505296707 12/31/2999 12/31/2999J7517 60505296801 12/31/2999 12/31/2999J7517 60505296805 12/31/2999 12/31/2999J7517 60505296807 12/31/2999 12/31/2999J7517 60951073470 1/31/2013 3/16/2012J7517 60951073570 8/31/2013 3/16/2012J7517 67263040701 12/31/2999 5/1/2011J7517 68084017701 12/31/2999 8/15/2012J7517 68084017711 12/31/2999 8/15/2012J7517 68084017801 12/31/2999 8/15/2012J7517 68084017811 12/31/2999 8/15/2012J7517 68084058701 12/31/2999 12/31/2999J7517 68084058801 12/31/2999 12/31/2999J7517 68382013001 12/31/2999 12/31/2999J7517 68382013005 12/31/2999 12/31/2999J7517 68382013101 12/31/2999 12/31/2999

Page 164: *This document is a compilation of NDC:HCPCS combinations

J7517 68382013105 12/31/2999 12/31/2999J7517 68382013110 12/31/2999 5/4/2009J7518 00078038566 12/31/2999 12/31/2999J7518 00078038666 12/31/2999 12/31/2999J7518 67263037812 12/31/2999 5/1/2011J7518 67263037912 12/31/2999 5/1/2011J7520 00008103004 12/31/2999 12/31/2999J7520 00008103006 12/31/2999 12/31/2999J7520 00008104005 12/31/2999 12/31/2999J7520 00008104010 12/31/2999 12/31/2999J7520 00008104105 12/31/2999 12/31/2999J7520 00008104110 12/31/2999 12/31/2999J7520 00008104205 12/31/2999 12/31/2999J7520 35356028000 12/31/2999 12/31/2999J7525 00469301601 12/31/2999 12/31/2999J7527 00078041420 12/31/2999 12/31/2999J7527 00078041520 12/31/2999 12/31/2999J7527 00078041720 12/31/2999 12/31/2999J7599 00003037113 12/31/2999 12/31/2999J7605 63402091130 12/31/2999 12/31/2999J7605 63402091164 12/31/2999 12/31/2999J7606 49502060530 12/31/2999 12/31/2999J7606 49502060561 12/31/2999 12/31/2999J7608 00054302502 12/31/2999 12/31/2999J7608 00054302602 12/31/2999 12/31/2999J7608 00054302702 12/31/2999 12/31/2999J7608 00054302802 12/31/2999 12/31/2999J7608 00074330801 12/31/2999 7/19/2011J7608 00409330703 12/31/2999 12/31/2999J7608 00409330803 12/31/2999 12/31/2999J7608 00517750425 12/31/2999 12/31/2999J7608 00517751003 12/31/2999 12/31/2999J7608 00517760425 12/31/2999 12/31/2999J7608 00517761003 12/31/2999 12/31/2999J7608 00517763003 12/31/2999 12/31/2999J7608 00574080530 12/31/2999 12/31/2999J7608 54868567000 12/31/2999 12/31/2999J7608 54868567001 12/31/2999 6/30/2012J7608 63323069030 12/31/2999 12/31/2999J7608 63323069210 12/31/2999 12/31/2999J7608 66220010730 12/31/2999 2/9/2011J7608 66220010734 12/31/2999 2/9/2011J7611 00378699052 4/30/2014 12/13/2012J7611 00378699058 4/30/2014 1/22/2013J7611 00378699091 1/31/2014 4/11/2013J7611 00378699093 12/31/2999 12/31/2999J7611 00487990102 12/31/2999 12/31/2999

Page 165: *This document is a compilation of NDC:HCPCS combinations

J7611 00487990130 12/31/2999 12/31/2999J7611 21695024520 12/31/2999 12/31/2999J7611 23490502102 12/31/2999 12/31/2999J7611 24208034720 12/31/2999 12/31/2999J7611 38779018401 12/31/2999 10/1/2001J7611 38779018404 12/31/2999 3/29/2004J7611 38779018405 12/31/2999 3/29/2004J7611 38779018501 12/31/2999 12/31/2999J7611 38779018504 12/31/2999 12/31/2999J7611 38779018505 12/31/2999 12/31/2999J7611 38779018508 12/31/2999 12/31/2999J7611 38779018509 12/31/2999 12/31/2999J7611 50383074120 12/31/2999 12/31/2999J7611 51552004402 12/31/2999 10/31/2011J7611 51552004404 12/31/2999 10/31/2011J7611 51552004405 12/31/2999 10/31/2011J7611 51552004406 12/31/2999 10/31/2011J7611 51552004407 12/31/2999 10/31/2011J7611 51927157300 12/31/2999 12/31/2999J7611 52959074120 12/31/2999 12/31/2999J7611 52959129400 12/31/2999 12/31/1999J7611 54569390000 12/31/2999 12/31/2999J7611 54868247201 12/31/2999 12/31/2999J7611 54868340700 12/31/2999 12/31/2999J7611 58016640401 12/31/2999 11/29/2012J7611 62991100601 12/31/2999 12/31/2999J7611 62991100602 12/31/2999 12/31/2999J7611 62991100603 12/31/2999 12/31/2999J7611 62991100604 12/31/2999 12/31/2999J7611 62991100605 12/31/2999 11/1/2006J7611 62991100606 12/31/2999 11/1/2006J7611 63370001015 12/31/2999 5/15/2008J7611 63370001025 12/31/2999 5/15/2008J7611 63370001035 12/31/2999 5/15/2008J7611 63370001045 12/31/2999 5/15/2008J7611 63370001050 12/31/2999 5/15/2008J7611 68115071120 12/31/2999 4/1/2009J7612 00378699393 12/31/2999 12/31/2999J7612 21695015324 12/31/2999 12/31/2999J7612 35356048903 12/31/2999 12/31/2999J7612 54569474800 12/31/2999 12/31/2999J7612 54569544500 12/31/2999 12/31/2999J7612 54868440900 12/31/2999 12/31/2999J7612 54868545900 12/31/2999 12/31/2999J7612 54868602100 12/31/2999 12/31/2999J7612 63402051124 12/31/2999 12/31/2999J7612 63402051224 12/31/2999 12/31/2999

Page 166: *This document is a compilation of NDC:HCPCS combinations

J7612 63402051324 12/31/2999 12/31/2999J7612 63402051530 12/31/2999 12/31/2999J7613 00378699052 4/30/2014 12/13/2012J7613 00378699058 4/30/2014 1/22/2013J7613 00378699091 1/31/2014 4/11/2013J7613 00378699093 12/31/2999 12/31/2999J7613 00378699152 12/31/2999 12/31/2999J7613 00378699252 12/31/2999 12/31/2999J7613 00378827052 12/31/2999 12/31/2999J7613 00378827091 12/31/2999 12/31/2999J7613 00378827093 12/31/2999 12/31/2999J7613 00487030101 12/31/2999 12/31/2999J7613 00487030102 12/31/2999 12/31/2999J7613 00487950101 12/31/2999 12/31/2999J7613 00487950102 12/31/2999 12/31/2999J7613 00487950103 12/31/2999 12/31/2999J7613 00487950125 12/31/2999 12/31/2999J7613 00487950160 12/31/2999 12/31/2999J7613 00487990401 12/31/2999 12/31/2999J7613 00487990402 12/31/2999 12/31/2999J7613 00487990425 12/31/2999 12/31/2999J7613 00591346753 12/31/2999 12/31/2999J7613 00591346853 12/31/2999 12/31/2999J7613 00591379730 12/31/2999 12/31/2999J7613 00591379760 12/31/2999 12/31/2999J7613 00591379783 12/31/2999 12/31/2999J7613 00603100540 12/31/2999 10/14/2004J7613 00781715529 12/31/2999 12/31/2999J7613 00781715564 12/31/2999 12/31/2999J7613 00781715586 12/31/2999 12/31/2999J7613 21695033225 12/31/2999 12/31/2999J7613 23490502001 12/31/2999 12/31/2999J7613 23490502002 12/31/2999 12/31/2999J7613 49502069203 12/31/2999 12/31/2999J7613 49502069303 12/31/2999 12/31/2999J7613 49502069724 12/31/2999 7/31/2012J7613 49502069730 12/31/2999 6/30/2012J7613 49999034425 12/31/2999 12/31/2999J7613 54569389900 12/31/2999 12/31/2999J7613 54868247200 12/31/2999 12/31/2999J7613 54868247201 12/31/2999 12/31/2999J7613 54868570900 12/31/2999 12/31/2999J7613 55045204307 12/31/2999 12/31/2999J7613 76204020025 12/31/2999 12/31/2999J7613 76204020030 12/31/2999 12/31/2999J7613 76204020060 12/31/2999 12/31/2999J7614 00093414564 12/31/2999 12/31/2999

Page 167: *This document is a compilation of NDC:HCPCS combinations

J7614 00093414664 12/31/2999 12/31/2999J7614 00093414864 12/31/2999 12/31/2999J7614 00378699393 12/31/2999 12/31/2999J7614 00378968044 12/31/2999 12/31/2999J7614 00378968144 12/31/2999 12/31/2999J7614 00378968244 12/31/2999 12/31/2999J7614 00591291823 12/31/2999 12/31/2999J7614 00591291923 12/31/2999 12/31/2999J7614 00591292023 12/31/2999 12/31/2999J7614 21695015324 12/31/2999 12/31/2999J7614 35356048903 12/31/2999 12/31/2999J7614 54569474800 12/31/2999 12/31/2999J7614 54569544500 12/31/2999 12/31/2999J7614 54868440900 12/31/2999 12/31/2999J7614 54868545900 12/31/2999 12/31/2999J7614 54868602100 12/31/2999 12/31/2999J7614 63402051124 12/31/2999 12/31/2999J7614 63402051224 12/31/2999 12/31/2999J7614 63402051324 12/31/2999 12/31/2999J7614 63402051530 12/31/2999 12/31/2999J7614 66993002127 12/31/2999 12/31/2999J7614 66993002227 12/31/2999 12/31/2999J7614 66993002327 12/31/2999 12/31/2999J7614 76204000224 12/31/2999 12/31/2999J7614 76204000324 12/31/2999 12/31/2999J7620 00093672373 12/31/2999 12/31/2999J7620 00093672374 12/31/2999 12/31/2999J7620 00185732230 12/31/2999 12/31/2999J7620 00185732260 12/31/2999 12/31/2999J7620 00378698858 12/31/2999 12/31/2999J7620 00378698891 12/31/2999 12/31/2999J7620 00378698893 12/31/2999 6/13/2013J7620 00378967158 12/31/2999 12/31/2999J7620 00378967193 12/31/2999 12/31/2999J7620 00487020101 12/31/2999 12/31/2999J7620 00487020102 12/31/2999 12/31/2999J7620 00487020103 12/31/2999 12/31/2999J7620 00487020160 12/31/2999 12/31/2999J7620 00591343330 12/31/2999 5/13/2013J7620 00591343360 12/31/2999 5/13/2013J7620 00591381730 12/31/2999 12/31/2999J7620 00591381760 12/31/2999 12/31/2999J7620 00781714629 12/31/2999 12/31/2999J7620 00781714664 12/31/2999 12/31/2999J7620 16252054733 12/31/2999 12/31/2999J7620 16252054766 12/31/2999 5/31/2013J7620 49502067230 12/31/2999 12/31/2999

Page 168: *This document is a compilation of NDC:HCPCS combinations

J7620 49502067260 12/31/2999 12/31/2999J7620 54868094800 12/31/2999 6/30/2012J7620 54868597400 12/31/2999 12/31/2999J7620 76204060005 12/31/2999 12/31/2999J7620 76204060012 12/31/2999 12/31/2999J7626 00093681573 12/31/2999 12/31/2999J7626 00093681645 12/31/2999 12/31/2999J7626 00093681673 12/31/2999 12/31/2999J7626 00186042504 12/31/2999 11/20/2008J7626 00186042604 12/31/2999 11/20/2008J7626 00186198804 12/31/2999 12/31/2999J7626 00186198904 12/31/2999 12/31/2999J7626 00186199004 12/31/2999 12/31/2999J7626 54868342300 12/31/2999 12/31/2999J7626 54868355000 12/31/2999 12/31/2999J7626 54868562100 12/31/2999 12/31/2999J7626 54868577400 12/31/2999 12/31/2999J7631 00172640649 12/31/2999 12/31/2999J7631 00172640659 12/31/2999 12/31/2999J7631 00472075221 12/31/2999 8/31/2007J7631 00472075260 12/31/2999 8/31/2007J7631 54868355500 12/31/2999 6/30/2010J7631 60505080201 12/31/2999 7/20/2007J7639 50242010039 12/31/2999 12/31/2999J7639 50242010040 12/31/2999 12/31/2999J7643 00517460125 12/31/2999 12/31/2999J7643 00517460225 12/31/2999 12/31/2999J7643 00517460525 12/31/2999 12/31/2999J7643 00517462025 12/31/2999 12/31/2999J7643 10019001602 4/30/2014 10/10/2012J7643 10019001617 3/31/2014 10/10/2012J7643 10019001629 4/30/2014 10/10/2012J7643 10019001654 1/31/2014 7/25/2012J7643 10019001681 3/31/2014 9/7/2012J7643 54868323101 12/31/2999 6/30/2001J7643 60977015501 3/31/2014 10/19/2012J7643 60977015502 3/31/2014 10/19/2012J7643 60977015503 1/31/2014 7/25/2012J7643 60977015506 10/31/2013 7/25/2012J7643 60977015554 1/31/2014 7/25/2012J7644 00378698962 12/31/2013 4/3/2013J7644 00378698964 12/31/2013 2/19/2013J7644 00378698966 9/30/2013 3/4/2013J7644 00378698993 12/31/2999 12/31/2999J7644 00378797052 12/31/2999 12/31/2999J7644 00378797091 12/31/2999 12/31/2999J7644 00378797093 12/31/2999 12/31/2999

Page 169: *This document is a compilation of NDC:HCPCS combinations

J7644 00487980101 12/31/2999 12/31/2999J7644 00487980102 12/31/2999 12/31/2999J7644 00487980125 12/31/2999 12/31/2999J7644 00487980130 12/31/2999 12/31/2999J7644 00487980160 12/31/2999 12/31/2999J7644 00591379830 12/31/2999 12/31/2999J7644 00591379860 12/31/2999 12/31/2999J7644 00591379883 12/31/2999 12/31/2999J7644 00781715729 12/31/2999 12/31/2999J7644 00781715764 12/31/2999 12/31/2999J7644 00781715786 12/31/2999 12/31/2999J7644 16252009866 3/31/2013 5/23/2011J7644 21695091125 12/31/2999 12/13/2011J7644 23490576101 12/31/2999 12/31/2999J7644 35356012425 12/31/2999 12/31/2999J7644 49502068530 12/31/2999 11/30/2011J7644 49502068531 12/31/2999 6/30/2012J7644 49502068562 12/31/2999 5/31/2012J7644 54569491000 12/31/2999 12/31/2999J7644 54868408200 12/31/2999 12/31/2999J7644 54868408201 12/31/2999 12/31/2999J7644 55045193005 12/31/2999 1/1/2003J7644 60505080601 12/31/2999 9/13/2007J7644 76204010001 12/31/2999 12/31/2999J7644 76204010025 12/31/2999 12/31/2999J7644 76204010030 12/31/2999 12/31/2999J7644 76204010060 12/31/2999 12/31/2999J7659 00409141001 12/31/2999 12/31/2999J7659 00409141005 12/31/2999 12/31/2999J7660 00409141001 12/31/2999 12/31/2999J7660 00409141005 12/31/2999 12/31/2999J7665 44178055201 12/31/2999 12/31/2999J7669 52959134306 12/31/2999 1/2/2001J7674 64281010006 12/31/2999 12/31/2999J7674 64281010012 12/31/2999 4/20/2010J7676 63323011310 12/31/2999 12/31/2999J7682 00078049471 12/31/2999 12/31/2999J7682 00093408563 12/31/2999 12/31/2999J7682 39822041201 12/31/2999 12/31/2999J7682 39822041206 12/31/2999 12/31/2999J7682 63323030351 12/31/2999 12/31/2999J7682 63323030355 12/31/2999 12/31/2999J7685 39822041201 12/31/2999 12/31/2999J7685 39822041206 12/31/2999 12/31/2999J7685 63323030351 12/31/2999 12/31/2999J7685 63323030355 12/31/2999 12/31/2999J7686 66302020601 12/31/2999 12/31/2999

Page 170: *This document is a compilation of NDC:HCPCS combinations

J7686 66302020602 12/31/2999 12/31/2999J7686 66302020603 12/31/2999 12/31/2999J7699 00085140101 12/31/2999 12/31/2999J7699 00085140201 12/31/2999 12/31/2999J7699 00378699889 12/31/2999 12/31/2999J7699 49502064115 12/31/2999 6/30/2012J7699 54868497200 12/31/2999 6/30/2012J7699 54868497201 12/31/2999 6/30/2011J7699 63323011310 12/31/2999 12/31/2999J7699 63402091130 12/31/2999 12/31/2999J7699 63402091164 12/31/2999 12/31/2999J7699 66302020603 12/31/2999 12/31/2999J7799 00053759603 12/31/2999 2/10/2010J7799 00053759610 5/6/2013 2/24/2011J7799 00053759620 6/8/2013 2/24/2011J7799 00074490222 12/31/2999 7/19/2011J7799 00074564125 12/31/2999 7/19/2011J7799 00264124055 12/31/2999 12/31/2999J7799 00264128050 12/31/2999 12/31/2999J7799 00264128055 9/30/2014 12/31/2999J7799 00264129050 5/31/2013 5/31/2013J7799 00264129055 12/31/2999 12/31/2999J7799 00264230350 12/31/2999 12/31/2999J7799 00264402155 9/30/2015 12/31/2999J7799 00264752000 12/31/2999 12/31/2999J7799 00264752010 12/31/2999 12/31/2999J7799 00264752020 12/31/2999 12/31/2999J7799 00264757810 12/31/2999 12/31/2999J7799 00264757820 12/31/2999 12/31/2999J7799 00264760500 12/31/2999 12/31/2999J7799 00264760510 12/31/2999 12/31/2999J7799 00264761200 12/31/2999 12/31/2999J7799 00264761210 12/31/2999 12/31/2999J7799 00264761220 12/31/2999 12/31/2999J7799 00264761400 12/31/2999 12/31/2999J7799 00264761410 12/31/2999 12/31/2999J7799 00264761600 12/31/2999 12/31/2999J7799 00264761610 12/31/2999 12/31/2999J7799 00264761620 12/31/2999 12/31/2999J7799 00264762200 12/31/2999 12/31/2999J7799 00264762320 12/31/2999 12/31/2999J7799 00264780200 12/31/2999 12/31/2999J7799 00264780210 12/31/2999 12/31/2999J7799 00264780510 12/31/2999 12/31/2999J7799 00264780610 12/31/2999 12/31/2999J7799 00338002302 12/31/2999 12/31/2999J7799 00338002303 12/31/2999 12/31/2999

Page 171: *This document is a compilation of NDC:HCPCS combinations

J7799 00338002304 12/31/2999 12/31/2999J7799 00338003106 12/31/2999 12/31/2010J7799 00338004303 12/31/2999 12/31/2999J7799 00338004304 12/31/2999 12/31/2999J7799 00338005403 12/31/2999 12/31/2999J7799 00338005603 12/31/2999 12/31/2999J7799 00338007304 12/31/2999 12/31/2999J7799 00338007702 12/31/2999 12/31/2999J7799 00338007703 12/31/2999 12/31/2999J7799 00338007704 12/31/2999 12/31/2999J7799 00338008103 12/31/2999 12/31/2999J7799 00338008502 12/31/2999 12/31/2999J7799 00338008503 12/31/2999 12/31/2999J7799 00338008504 12/31/2999 12/31/2999J7799 00338035104 12/31/2999 12/31/2999J7799 00338035303 12/31/2999 12/31/2999J7799 00338035503 12/31/2999 12/31/2999J7799 00338035702 12/31/2999 12/31/2999J7799 00338035703 12/31/2999 12/31/2999J7799 00338071906 12/31/2999 12/31/2999J7799 00338071913 12/31/2999 12/31/2999J7799 00338634703 12/31/2999 12/31/2999J7799 00409113002 12/31/2999 12/31/2999J7799 00409114102 12/31/2999 12/31/2999J7799 00409158603 12/31/2999 12/31/2999J7799 00409177510 12/31/2999 12/31/2999J7799 00409421902 12/31/2999 1/1/2012J7799 00409486202 12/31/2999 12/31/2999J7799 00409490234 12/31/2999 12/31/2999J7799 00409664802 12/31/2999 12/31/2999J7799 00409665773 12/31/2999 12/31/2999J7799 00409666075 12/31/2999 12/31/2999J7799 00409712007 12/31/2999 12/31/2999J7799 00409713202 12/31/2999 12/31/2999J7799 00409713266 12/31/2999 12/31/2999J7799 00409713267 12/31/2999 12/31/2999J7799 00409751716 12/31/2999 12/31/2999J7799 00409771209 12/31/2999 12/31/2999J7799 00409771309 12/31/2999 12/31/2999J7799 00409771502 12/31/2999 12/31/2999J7799 00409771503 12/31/2999 12/31/2999J7799 00409773020 12/31/2999 12/31/2999J7799 00409773036 12/31/2999 12/31/2999J7799 00409773037 12/31/2999 12/31/2999J7799 00409791819 12/31/2999 12/31/2999J7799 00409792402 12/31/2999 12/31/2999J7799 00409792403 12/31/2999 12/31/2999

Page 172: *This document is a compilation of NDC:HCPCS combinations

J7799 00409792409 12/31/2999 12/31/2999J7799 00409792503 12/31/2999 12/31/2999J7799 00409792509 12/31/2999 12/31/2999J7799 00409792602 12/31/2999 12/31/2999J7799 00409792603 12/31/2999 12/31/2999J7799 00409792609 12/31/2999 12/31/2999J7799 00409792630 12/31/2999 12/31/2999J7799 00409792648 12/31/2999 12/31/2999J7799 00409793002 12/31/2999 12/31/2999J7799 00409793003 12/31/2999 12/31/2999J7799 00409793009 12/31/2999 12/31/2999J7799 00409793519 12/31/2999 12/31/2999J7799 00409793619 12/31/2999 12/31/2999J7799 00409793719 12/31/2999 12/31/2999J7799 00409793819 12/31/2999 12/31/2999J7799 00409798502 12/31/2999 12/31/2999J7799 00409798503 12/31/2999 12/31/2999J7799 00409798509 12/31/2999 12/31/2999J7799 00409798525 12/31/2999 12/31/2999J7799 00409800415 12/31/2999 12/31/2999J7799 00469325010 12/31/2999 12/31/2999J7799 00517290025 1/31/2013 12/1/2011J7799 00517293025 12/31/2999 12/31/2999J7799 00548330100 9/30/2014 11/29/2012J7799 54868308900 12/31/2999 6/30/2011J7799 54868308901 12/31/2999 6/30/2011J7799 54868370300 12/31/2999 6/30/2011J7799 63323008861 12/31/2999 12/31/2999J7799 63323008863 12/31/2999 12/31/2999J7799 63323013920 12/31/2999 2/15/2013J7799 63323013940 12/31/2999 12/31/2999J7799 63323018730 12/31/2999 12/31/2999J8498 00574722612 12/31/2999 12/31/2999J8498 00574723412 7/31/2014 4/3/2013J8498 00574723612 7/31/2014 2/12/2013J8498 00713013212 12/31/2999 12/31/2999J8498 00713013506 12/31/2999 12/31/2999J8498 00713013512 12/31/2999 12/31/2999J8498 00713052612 12/31/2999 12/31/2999J8498 00713053612 12/31/2999 12/31/2999J8498 16590019312 12/31/2999 12/31/2999J8498 16590019412 12/31/2999 12/31/2999J8498 21695064912 12/31/2999 12/31/2999J8498 23490617401 12/31/2999 12/31/2999J8498 23490618001 12/31/2999 12/31/2999J8498 23490618201 12/31/2999 12/31/2999J8498 23490618202 12/31/2999 12/31/2999

Page 173: *This document is a compilation of NDC:HCPCS combinations

J8498 23490618203 12/31/2999 12/31/2999J8498 33358030102 12/31/2999 12/31/2999J8498 33358030112 12/31/2999 12/31/2999J8498 35356003912 12/31/2999 12/31/2999J8498 43063006002 12/31/2999 12/31/2999J8498 45802075830 12/31/2999 12/31/2999J8498 45802075930 12/31/2999 12/31/2999J8498 49999033912 12/31/2999 12/31/2999J8498 49999034012 12/31/2999 12/31/2999J8498 52959023712 12/31/2999 12/31/2999J8498 52959035506 12/31/2999 12/31/2999J8498 52959035512 12/31/2999 12/31/2999J8498 52959073112 12/31/2999 12/31/2999J8498 54569472000 12/31/2999 12/31/2999J8498 54569472002 12/31/2999 12/31/2999J8498 54569574400 12/31/2999 12/31/2999J8498 54569574401 12/31/2999 12/31/2999J8498 54569574500 12/31/2999 4/3/2013J8498 54569574501 12/31/2999 4/3/2013J8498 54569574502 12/31/2999 4/3/2013J8498 54868060101 12/31/2999 12/31/2999J8498 54868060102 12/31/2999 12/31/2999J8498 54868161300 12/31/2999 6/30/2012J8498 54868161301 12/31/2999 6/30/2012J8498 54868161302 12/31/2999 6/30/2012J8498 54868311200 12/31/2999 12/31/2999J8498 54868311201 12/31/2999 12/31/2999J8498 54868479401 12/31/2999 12/31/2999J8498 54868479402 12/31/2999 12/31/2999J8498 55289011902 12/31/2999 12/31/2999J8498 55289011906 12/31/2999 12/31/2999J8498 55289092802 12/31/2999 12/31/2999J8498 55289092804 12/31/2999 12/31/2999J8498 55289092806 12/31/2999 12/31/2999J8498 55289092879 12/31/2999 12/31/2999J8498 55289094002 12/31/2999 12/31/2999J8498 58016007800 12/31/2999 11/29/2012J8498 58016007830 12/31/2999 11/29/2012J8498 58016007860 12/31/2999 11/29/2012J8498 58016007890 12/31/2999 11/29/2012J8498 58016500901 12/31/2999 11/29/2012J8498 58016650612 12/31/2999 11/29/2012J8498 66267017602 12/31/2999 12/31/2999J8499 00093894001 12/31/2999 12/31/2999J8499 00093894005 12/31/2999 12/31/2999J8499 00093894093 4/30/2014 11/27/2012J8499 00093894301 12/31/2999 12/31/2999

Page 174: *This document is a compilation of NDC:HCPCS combinations

J8499 00093894305 12/31/2999 12/31/2999J8499 00093894393 6/30/2014 11/20/2012J8499 00093894701 12/31/2999 12/31/2999J8499 00093894705 12/31/2999 12/31/2999J8499 00093894793 4/30/2014 11/27/2012J8499 00173094555 12/31/2999 12/31/2999J8499 00173094955 12/31/2999 12/31/2999J8499 00173095396 12/31/2999 12/31/2999J8499 00173099155 12/31/2999 12/31/2999J8499 00378025301 12/31/2999 12/31/2999J8499 00378030201 12/31/2999 12/31/2999J8499 00440103130 12/31/2999 12/31/2999J8499 00440703005 12/31/2999 12/31/2999J8499 00440703025 12/31/2999 12/31/2999J8499 00440703030 12/31/2999 12/31/2999J8499 00440703050 12/31/2999 12/31/2999J8499 00440703060 12/31/2999 12/31/2999J8499 00440703125 12/31/2999 12/31/2999J8499 00440703310 12/31/2999 12/31/2999J8499 00440703320 12/31/2999 12/31/2999J8499 00440703350 12/31/2999 12/31/2999J8499 00472008216 12/31/2999 12/31/2999J8499 00904612161 12/31/2999 12/31/2999J8499 16477051008 12/31/2999 12/31/2999J8499 16590000330 12/31/2999 12/31/2999J8499 16590000360 12/31/2999 12/31/2999J8499 21695000925 12/31/2999 12/31/2999J8499 21695001020 12/31/2999 12/31/2999J8499 21695001025 12/31/2999 12/31/2999J8499 21695001030 12/31/2999 12/31/2999J8499 21695001060 12/31/2999 12/31/2999J8499 21695001125 12/31/2999 12/31/2999J8499 21695001130 12/31/2999 12/31/2999J8499 21695001135 12/31/2999 12/31/2999J8499 21695001140 12/31/2999 12/31/2999J8499 23490501101 12/31/2999 12/31/2999J8499 23490501201 12/31/2999 12/31/2999J8499 23490501202 12/31/2999 12/31/2999J8499 23490501203 12/31/2999 12/31/2999J8499 23490501204 12/31/2999 12/31/2999J8499 23490501301 12/31/2999 12/31/2999J8499 23490501302 12/31/2999 12/31/2999J8499 23490501303 12/31/2999 12/31/2999J8499 23490501304 12/31/2999 12/31/2999J8499 23490501501 12/31/2999 12/31/2999J8499 23490501502 12/31/2999 12/31/2999J8499 33358000925 12/31/2999 12/31/2999

Page 175: *This document is a compilation of NDC:HCPCS combinations

J8499 33358001015 12/31/2999 12/31/2999J8499 33358001028 12/31/2999 12/31/2999J8499 33358001030 12/31/2999 12/31/2999J8499 33358001060 12/31/2999 12/31/2999J8499 33358001125 12/31/2999 12/31/2999J8499 33358001130 12/31/2999 12/31/2999J8499 33358001135 12/31/2999 12/31/2999J8499 43063000101 12/31/2999 12/31/2999J8499 49999008600 12/31/2999 12/31/2999J8499 49999008621 12/31/2999 12/31/2999J8499 49999008625 12/31/2999 12/31/2999J8499 49999008630 12/31/2999 12/31/2999J8499 49999008690 12/31/2999 12/31/2999J8499 49999023135 12/31/2999 12/31/2999J8499 49999038510 12/31/2999 12/31/2999J8499 49999038515 12/31/2999 12/31/2999J8499 49999038525 12/31/2999 12/31/2999J8499 49999038540 12/31/2999 12/31/2999J8499 50383081016 12/31/2999 12/31/2999J8499 52959033000 12/31/2999 12/31/2999J8499 52959033025 12/31/2999 12/31/2999J8499 52959033050 12/31/2999 12/31/2999J8499 52959051725 12/31/2999 12/31/2999J8499 52959051730 12/31/2999 12/31/2999J8499 52959051735 12/31/2999 12/31/2999J8499 52959054401 12/31/2999 12/31/2999J8499 52959054410 12/31/2999 12/31/2999J8499 52959054412 12/31/2999 12/31/2999J8499 52959054415 12/31/2999 12/31/2999J8499 52959054421 12/31/2999 12/31/2999J8499 52959054425 12/31/2999 12/31/2999J8499 52959054430 12/31/2999 12/31/2999J8499 52959054440 12/31/2999 12/31/2999J8499 52959054450 12/31/2999 12/31/2999J8499 52959054460 12/31/2999 12/31/2999J8499 52959067830 12/31/2999 12/31/2999J8499 52959067840 12/31/2999 12/31/2999J8499 52959067850 12/31/2999 12/31/2999J8499 54569448200 12/31/2999 12/31/2999J8499 54569448201 12/31/2999 12/31/2999J8499 54569448204 12/31/2999 12/31/2999J8499 54569448206 12/31/2999 12/31/2999J8499 54569472400 12/31/2999 12/31/2999J8499 54569476501 12/31/2999 12/31/2999J8499 54569476502 12/31/2999 12/31/2999J8499 54569476503 12/31/2999 12/31/2999J8499 54569476504 12/31/2999 12/31/2999

Page 176: *This document is a compilation of NDC:HCPCS combinations

J8499 54569476505 12/31/2999 12/31/2999J8499 54569476506 12/31/2999 12/31/2999J8499 54569476509 12/31/2999 12/31/2999J8499 54868016302 12/31/2999 6/30/2012J8499 54868218400 12/31/2999 6/30/2012J8499 54868218402 12/31/2999 6/30/2012J8499 54868218403 12/31/2999 6/30/2012J8499 54868218404 12/31/2999 6/30/2012J8499 54868302500 12/31/2999 6/30/2010J8499 54868399600 12/31/2999 12/31/2999J8499 54868399601 12/31/2999 6/30/2011J8499 54868399602 12/31/2999 12/31/2999J8499 54868399603 12/31/2999 12/31/2999J8499 54868399604 12/31/2999 6/30/2011J8499 54868399605 12/31/2999 12/31/2999J8499 54868399700 12/31/2999 12/31/2999J8499 54868399701 12/31/2999 12/31/2999J8499 54868399702 12/31/2999 12/31/2999J8499 54868399703 12/31/2999 12/31/2999J8499 54868399704 12/31/2999 12/31/2999J8499 54868399705 12/31/2999 12/31/2999J8499 54868399800 12/31/2999 12/31/2999J8499 54868399801 12/31/2999 12/31/2999J8499 54868399802 12/31/2999 6/30/2011J8499 54868399803 12/31/2999 12/31/2999J8499 54868399804 12/31/2999 12/31/2999J8499 54868399805 12/31/2999 12/31/2999J8499 54868399806 12/31/2999 12/31/2999J8499 54868399808 12/31/2999 12/31/2999J8499 54868568700 12/31/2999 12/31/2999J8499 55289000610 12/31/2999 12/31/2999J8499 55289000625 12/31/2999 12/31/2999J8499 55289000635 12/31/2999 12/31/2999J8499 55289000650 12/31/2999 12/31/2999J8499 55289027310 12/31/2999 12/31/2999J8499 55289027325 12/31/2999 12/31/2999J8499 55289027330 12/31/2999 12/31/2999J8499 55289027335 12/31/2999 12/31/2999J8499 55289027350 12/31/2999 12/31/2999J8499 55289046205 12/31/2999 12/31/2999J8499 55289046212 12/31/2999 12/31/2999J8499 55289046215 12/31/2999 12/31/2999J8499 55289046221 12/31/2999 12/31/2999J8499 55289046225 12/31/2999 12/31/2999J8499 55289046230 12/31/2999 12/31/2999J8499 55289046235 12/31/2999 12/31/2999J8499 55289046260 12/31/2999 12/31/2999

Page 177: *This document is a compilation of NDC:HCPCS combinations

J8499 55289056415 12/31/2999 12/31/2999J8499 55289056420 12/31/2999 12/31/2999J8499 55289056448 12/31/2999 12/31/2999J8499 55289062910 12/31/2999 12/31/2999J8499 55289062920 12/31/2999 12/31/2999J8499 55289062930 12/31/2999 12/31/2999J8499 55289062935 12/31/2999 12/31/2999J8499 55289062940 12/31/2999 12/31/2999J8499 55289062950 12/31/2999 12/31/2999J8499 55289069112 12/31/2999 12/31/2999J8499 55289069115 12/31/2999 12/31/2999J8499 55289069125 12/31/2999 12/31/2999J8499 58016011100 12/31/2999 11/29/2012J8499 58016011115 12/31/2999 11/29/2012J8499 58016011120 12/31/2999 11/29/2012J8499 58016011125 12/31/2999 11/29/2012J8499 58016011130 12/31/2999 11/29/2012J8499 58016011160 12/31/2999 11/29/2012J8499 58016011190 12/31/2999 11/29/2012J8499 58016011200 12/31/2999 11/29/2012J8499 58016011220 12/31/2999 11/29/2012J8499 58016011230 12/31/2999 11/29/2012J8499 58016011260 12/31/2999 11/29/2012J8499 58016011290 12/31/2999 11/29/2012J8499 58016062700 12/31/2999 11/29/2012J8499 58016062720 12/31/2999 11/29/2012J8499 58016062730 12/31/2999 11/29/2012J8499 58016062760 12/31/2999 11/29/2012J8499 58016062790 12/31/2999 11/29/2012J8499 58864019125 12/31/2999 12/31/2999J8499 58864019135 12/31/2999 12/31/2999J8499 58864060201 12/31/2999 12/31/2999J8499 58864060230 12/31/2999 12/31/2999J8499 58864087635 12/31/2999 12/31/2999J8499 60429071150 12/31/2999 12/31/2999J8499 60429071350 12/31/2999 12/31/2999J8499 60505004206 12/31/2999 12/31/2999J8499 60505530601 12/31/2999 12/31/2999J8499 60505530608 12/31/2999 12/31/2999J8499 60505530701 12/31/2999 12/31/2999J8499 60505530705 12/31/2999 12/31/2999J8499 60760065225 12/31/2999 12/31/2999J8499 61442011101 12/31/2999 12/31/2999J8499 61442011201 12/31/2999 12/31/2999J8499 61442011301 12/31/2999 12/31/2999J8499 63304050401 12/31/2999 12/31/2999J8499 63304050501 12/31/2999 12/31/2999

Page 178: *This document is a compilation of NDC:HCPCS combinations

J8499 63304065201 12/31/2999 12/31/2999J8499 63629167705 12/31/2999 12/31/2999J8499 66267000625 12/31/2999 12/31/2999J8499 66267000640 12/31/2999 12/31/2999J8499 66267000650 12/31/2999 12/31/2999J8499 66267000715 12/31/2999 12/31/2999J8499 66267000721 12/31/2999 12/31/2999J8499 66267000725 12/31/2999 12/31/2999J8499 66267000730 12/31/2999 12/31/2999J8499 66267039930 12/31/2999 12/31/2999J8499 66267039935 12/31/2999 12/31/2999J8499 67253010010 12/31/2999 12/31/2999J8499 67253010011 12/31/2999 12/31/2999J8499 67253010110 12/31/2999 12/31/2999J8499 67253010111 12/31/2999 12/31/2999J8501 00006046102 12/31/2999 12/31/2999J8501 00006046106 12/31/2999 12/31/2999J8501 00006046206 12/31/2999 12/31/2999J8501 00006046405 12/31/2999 12/31/2999J8501 00006046410 12/31/2999 12/31/2999J8501 00006386203 12/31/2999 12/31/2999J8501 52959074801 12/31/2999 12/31/2999J8501 54569574100 12/31/2999 12/31/2999J8501 54868523101 12/31/2999 6/30/2011J8501 54868523102 12/31/2999 12/31/2999J8501 54868532500 12/31/2999 12/31/2999J8510 00173071325 3/31/2014 12/31/2999J8510 76388071325 12/31/2999 12/31/2999J8515 00093542088 12/31/2999 12/31/2999J8515 16252053608 12/31/2999 12/31/2999J8515 49884067314 12/31/2999 12/31/2999J8515 59762010001 12/31/2999 12/31/2999J8520 00004110020 12/31/2999 12/31/2999J8520 54868414300 12/31/2999 6/30/2011J8520 54868414301 12/31/2999 6/30/2011J8520 54868414302 12/31/2999 6/30/2011J8521 00004110150 12/31/2999 12/31/2999J8521 00004110175 12/31/2013 12/31/2999J8521 54868526000 12/31/2999 12/31/2999J8521 54868526001 12/31/2999 12/31/2999J8521 54868526002 12/31/2999 12/31/2999J8521 54868526003 12/31/2999 12/31/2999J8521 54868526004 12/31/2999 3/31/2011J8521 54868526005 12/31/2999 12/31/2999J8521 54868526006 12/31/2999 3/31/2011J8521 54868526007 12/31/2999 3/31/2011J8521 54868526008 12/31/2999 3/31/2011

Page 179: *This document is a compilation of NDC:HCPCS combinations

J8521 54868526009 12/31/2999 12/31/2999J8530 00054412925 12/31/2999 12/31/2999J8530 00054413025 12/31/2999 12/31/2999J8530 54868500500 12/31/2999 6/30/2012J8530 54868500501 12/31/2999 6/30/2011J8530 54868521800 12/31/2999 6/30/2012J8530 54868521801 12/31/2999 6/30/2012J8530 54868521802 12/31/2999 6/30/2011J8540 00054317644 12/31/2999 12/31/2999J8540 00054317757 12/31/2999 12/31/2999J8540 00054317763 12/31/2999 12/31/2999J8540 00054417925 12/31/2999 12/31/2999J8540 00054418025 12/31/2999 12/31/2999J8540 00054418125 12/31/2999 12/31/2999J8540 00054418225 12/31/2999 12/31/2999J8540 00054418325 12/31/2999 12/31/2999J8540 00054418425 12/31/2999 12/31/2999J8540 00054418625 12/31/2999 12/31/2999J8540 00054817425 12/31/2999 12/31/2999J8540 00054817525 12/31/2999 12/31/2999J8540 00054817625 12/31/2999 12/31/2999J8540 00054817925 12/31/2999 12/31/2999J8540 00054818025 12/31/2999 12/31/2999J8540 00054818125 12/31/2999 12/31/2999J8540 00054818325 12/31/2999 12/31/2999J8540 00095008735 12/31/2999 12/31/2999J8540 00095008851 12/31/2999 12/31/2999J8540 21695038204 12/31/2999 12/31/2999J8540 21695038220 12/31/2999 12/31/2999J8540 23490540401 12/31/2999 12/31/2999J8540 23490540701 12/31/2999 12/31/2999J8540 23490540702 12/31/2999 12/31/2999J8540 35356035930 12/31/2999 12/31/2999J8540 44183050735 7/31/2013 6/28/2011J8540 44183050851 7/31/2013 6/28/2011J8540 49884008401 12/31/2999 12/31/2999J8540 49884008501 12/31/2999 12/31/2999J8540 49884008601 12/31/2999 12/31/2999J8540 49884008701 12/31/2999 12/31/2999J8540 49884012901 12/31/2999 12/31/2999J8540 49999005906 12/31/2999 12/31/2999J8540 49999005930 12/31/2999 12/31/2999J8540 52959039212 12/31/2999 12/31/2999J8540 52959039228 12/31/2999 12/31/2999J8540 52959039230 12/31/2999 12/31/2999J8540 52959054710 12/31/2999 12/31/2999J8540 52959054711 12/31/2999 12/31/2999

Page 180: *This document is a compilation of NDC:HCPCS combinations

J8540 52959054712 12/31/2999 12/31/2999J8540 52959054716 12/31/2999 12/31/2999J8540 52959054720 12/31/2999 12/31/2999J8540 52959054730 12/31/2999 12/31/2999J8540 52959054750 12/31/2999 12/31/2999J8540 54569032200 12/31/2999 12/31/2999J8540 54569032203 12/31/2999 12/31/2999J8540 54569032404 12/31/2999 12/31/2999J8540 54569033601 12/31/2999 12/31/2999J8540 54569572900 12/31/2999 12/31/2999J8540 54868021800 12/31/2999 12/31/2999J8540 54868021801 12/31/2999 12/31/2999J8540 54868021802 12/31/2999 6/30/2012J8540 54868021803 12/31/2999 12/31/2999J8540 54868021804 12/31/2999 12/31/2999J8540 54868021805 12/31/2999 12/31/2999J8540 54868021806 12/31/2999 12/31/2999J8540 54868021807 12/31/2999 6/30/2012J8540 54868021808 12/31/2999 12/31/2999J8540 54868021809 12/31/2999 12/31/2999J8540 54868091600 12/31/2999 6/30/2012J8540 54868092700 12/31/2999 12/31/2999J8540 54868174400 12/31/2999 6/30/2012J8540 54868315701 12/31/2999 12/31/2999J8540 54868533400 12/31/2999 12/31/2999J8540 55289058204 12/31/2999 12/31/2999J8540 55289058206 12/31/2999 12/31/2999J8540 55289058210 12/31/2999 12/31/2999J8540 55289058228 12/31/2999 12/31/2999J8540 55289090310 12/31/2999 12/31/2999J8540 55289090320 12/31/2999 12/31/2999J8540 58016029000 12/31/2999 11/29/2012J8540 58016029002 12/31/2999 11/29/2012J8540 58016029003 12/31/2999 11/29/2012J8540 58016029012 12/31/2999 11/29/2012J8540 58016029015 12/31/2999 11/29/2012J8540 58016029020 12/31/2999 11/29/2012J8540 58016029030 12/31/2999 11/29/2012J8540 58016029073 12/31/2999 11/29/2012J8540 58016029089 12/31/2999 11/29/2012J8540 58016029160 12/31/2999 11/29/2012J8540 58016029300 12/31/2999 11/29/2012J8540 58016029312 12/31/2999 11/29/2012J8540 58016029315 12/31/2999 11/29/2012J8540 58016029320 12/31/2999 11/29/2012J8540 58016029330 12/31/2999 11/29/2012J8540 58016078100 12/31/2999 11/29/2012

Page 181: *This document is a compilation of NDC:HCPCS combinations

J8540 58016078110 12/31/2999 11/29/2012J8540 58016078112 12/31/2999 11/29/2012J8540 58016078114 12/31/2999 11/29/2012J8540 58016078115 12/31/2999 11/29/2012J8540 58016078120 12/31/2999 11/29/2012J8540 58016078121 12/31/2999 11/29/2012J8540 58016078124 12/31/2999 11/29/2012J8540 58016078128 12/31/2999 11/29/2012J8540 58016078130 12/31/2999 11/29/2012J8540 58016078140 12/31/2999 11/29/2012J8540 58016078150 12/31/2999 11/29/2012J8540 60432046608 12/31/2999 12/31/2999J8540 64679081008 12/31/2999 12/31/2999J8540 66267006612 12/31/2999 12/31/2999J8540 66267006630 12/31/2999 12/31/2999J8540 66267006704 12/31/2999 12/31/2999J8540 66267006708 12/31/2999 12/31/2999J8540 66267006710 12/31/2999 12/31/2999J8540 66267006712 12/31/2999 12/31/2999J8540 66267006720 12/31/2999 12/31/2999J8540 66267006721 12/31/2999 12/31/2999J8560 00378326694 12/31/2999 12/31/2999J8560 54868535500 12/31/2999 6/30/2011J8560 54868535502 12/31/2999 6/30/2011J8561 00078041420 12/31/2999 12/31/2999J8561 00078041520 12/31/2999 12/31/2999J8561 00078041720 12/31/2999 12/31/2999J8565 00310048230 12/31/2999 1/1/2012J8600 52609000105 12/31/2999 12/31/2999J8600 54868433900 12/31/2999 6/30/2012J8600 54868433901 12/31/2999 6/30/2012J8600 54868433902 12/31/2999 6/30/2011J8600 54868433903 12/31/2999 6/30/2012J8600 54868433904 12/31/2999 6/30/2012J8600 59572030250 12/31/2999 3/31/2009J8610 00054455015 12/31/2999 12/31/2999J8610 00054455025 12/31/2999 12/31/2999J8610 00054855025 12/31/2999 12/31/2999J8610 00378001401 12/31/2999 12/31/2999J8610 00378001450 12/31/2999 12/31/2999J8610 00555057202 12/31/2999 12/31/2999J8610 00555057235 12/31/2999 12/31/2999J8610 00555057245 12/31/2999 11/14/2002J8610 00555057246 12/31/2999 12/10/2002J8610 00555057247 12/31/2999 1/17/2003J8610 00555057248 12/31/2999 11/14/2002J8610 00555057249 12/31/2999 11/14/2002

Page 182: *This document is a compilation of NDC:HCPCS combinations

J8610 00904601260 12/31/2999 12/4/2012J8610 21695011100 12/31/2999 12/31/2999J8610 23490588900 12/31/2999 12/31/2999J8610 49999038024 12/31/2999 12/31/2999J8610 49999038036 12/31/2999 12/31/2999J8610 51079067001 12/31/2999 12/31/2999J8610 51079067005 12/31/2999 12/31/2999J8610 51285036601 12/31/2999 12/31/2999J8610 51285036701 12/31/2999 12/31/2999J8610 51285036801 12/31/2999 12/31/2999J8610 51285036901 12/31/2999 12/31/2999J8610 52959024400 12/31/2999 12/31/2999J8610 54569181809 12/31/2999 12/31/2999J8610 54868382601 12/31/2999 12/31/2999J8610 54868382603 12/31/2999 12/31/2999J8610 54868382604 12/31/2999 12/31/2999J8610 54868382605 12/31/2999 12/31/2999J8610 54868382606 12/31/2999 6/30/2011J8610 54868382607 12/31/2999 6/30/2011J8610 55289092430 12/31/2999 12/31/2999J8610 67253032010 12/31/2999 12/31/2999J8610 67253032036 12/31/2999 12/31/2999J8610 67253058042 12/31/2999 12/31/2999J8610 67253058043 12/31/2999 12/31/2999J8610 67253058044 12/31/2999 12/31/2999J8610 67253058045 12/31/2999 12/31/2999J8610 67253058046 12/31/2999 12/31/2999J8610 68115063200 12/31/2999 4/1/2009J8700 00085124401 12/31/2999 1/5/2009J8700 00085124402 12/31/2999 1/5/2009J8700 00085124801 12/31/2999 1/5/2009J8700 00085124802 12/31/2999 1/5/2009J8700 00085124803 12/31/2999 12/31/2999J8700 00085125201 12/31/2999 1/5/2009J8700 00085125202 12/31/2999 1/5/2009J8700 00085125901 12/31/2999 1/5/2009J8700 00085125902 12/31/2999 1/5/2009J8700 00085136601 12/31/2999 12/31/2999J8700 00085136602 12/31/2999 12/31/2999J8700 00085136603 12/31/2999 12/31/2999J8700 00085136604 12/31/2999 12/31/2999J8700 00085141701 12/31/2999 12/31/2999J8700 00085141702 12/31/2999 12/31/2999J8700 00085142501 12/31/2999 12/31/2999J8700 00085142502 12/31/2999 12/31/2999J8700 00085142503 12/31/2999 12/31/2999J8700 00085142504 12/31/2999 12/31/2999

Page 183: *This document is a compilation of NDC:HCPCS combinations

J8700 00085143001 12/31/2999 12/31/2999J8700 00085143002 12/31/2999 12/31/2999J8700 00085143003 12/31/2999 12/31/2999J8700 00085143004 12/31/2999 12/31/2999J8700 00085151901 12/31/2999 12/31/2999J8700 00085151902 12/31/2999 12/31/2999J8700 00085151903 12/31/2999 12/31/2999J8700 00085151904 12/31/2999 12/31/2999J8700 00085300401 12/31/2999 12/31/2999J8700 00085300402 12/31/2999 12/31/2999J8700 00085300403 12/31/2999 12/31/2999J8700 00085300404 12/31/2999 12/31/2999J8700 00093759941 12/31/2999 12/31/2999J8700 00093759957 12/31/2999 12/31/2999J8700 00093760041 12/31/2999 12/31/2999J8700 00093760057 12/31/2999 12/31/2999J8700 00093760141 12/31/2999 12/31/2999J8700 00093760157 12/31/2999 12/31/2999J8700 00093760257 12/31/2999 12/31/2999J8700 00093763841 12/31/2999 12/31/2999J8700 00093763857 12/31/2999 12/31/2999J8700 00093763941 12/31/2999 12/31/2999J8700 00093763957 12/31/2999 12/31/2999J8700 00781269144 12/31/2999 12/31/2999J8700 00781269175 12/31/2999 12/31/2999J8700 00781269244 12/31/2999 12/31/2999J8700 00781269275 12/31/2999 12/31/2999J8700 00781269344 12/31/2999 12/31/2999J8700 00781269375 12/31/2999 12/31/2999J8700 00781269444 12/31/2999 12/31/2999J8700 00781269475 12/31/2999 12/31/2999J8700 00781269544 12/31/2999 12/31/2999J8700 00781269575 12/31/2999 12/31/2999J8700 00781269675 12/31/2999 12/31/2999J8700 54868414200 12/31/2999 6/30/2012J8700 54868414201 12/31/2999 5/31/2011J8700 54868414202 12/31/2999 6/30/2012J8700 54868414204 12/31/2999 6/30/2012J8700 54868414205 12/31/2999 6/30/2012J8700 54868414206 12/31/2999 6/30/2012J8700 54868534800 12/31/2999 5/31/2011J8700 54868534801 12/31/2999 6/30/2012J8700 54868535000 12/31/2999 6/30/2012J8700 54868535001 12/31/2999 5/31/2011J8700 54868535002 12/31/2999 6/30/2012J8700 54868535003 12/31/2999 6/30/2012J8700 54868535004 12/31/2999 6/30/2012

Page 184: *This document is a compilation of NDC:HCPCS combinations

J8700 54868535400 12/31/2999 6/30/2012J8700 54868598000 12/31/2999 12/31/2999J8700 67263056088 12/31/2999 5/1/2011J8705 00007420511 12/31/2999 12/31/2999J8705 00007420711 12/31/2999 12/31/2999J8999 00003083050 12/31/2999 12/31/2999J8999 00003633517 12/31/2999 12/31/2999J8999 00003633617 12/31/2999 12/31/2999J8999 00003633717 12/31/2999 12/31/2999J8999 00007420511 12/31/2999 12/31/2999J8999 00007420711 12/31/2999 12/31/2999J8999 00009766304 12/31/2999 12/31/2999J8999 00015050842 12/31/2999 12/31/2999J8999 00015303020 12/31/2999 12/31/2999J8999 00015303120 12/31/2999 12/31/2999J8999 00015303220 12/31/2999 12/31/2999J8999 00054354258 12/31/2999 12/31/2999J8999 00054458111 12/31/2999 12/31/2999J8999 00054458127 12/31/2999 12/31/2999J8999 00054460325 12/31/2999 12/31/2999J8999 00054460425 12/31/2999 12/31/2999J8999 00054860325 12/31/2999 12/31/2999J8999 00054860425 12/31/2999 12/31/2999J8999 00085136602 12/31/2999 12/31/2999J8999 00085141701 12/31/2999 12/31/2999J8999 00085151902 12/31/2999 12/31/2999J8999 00093078201 12/31/2999 12/31/2999J8999 00093078205 12/31/2999 12/31/2999J8999 00093078210 12/31/2999 12/31/2999J8999 00093078256 12/31/2999 12/31/2999J8999 00093078405 12/31/2999 12/31/2999J8999 00093078406 12/31/2999 12/31/2999J8999 00093078410 12/31/2999 12/31/2999J8999 00093078486 12/31/2999 12/31/2999J8999 00093551006 12/31/2999 12/31/2999J8999 00121477610 12/31/2999 12/31/2999J8999 00121477620 12/31/2999 2/23/2012J8999 00172496058 12/31/2999 12/31/2999J8999 00172496070 12/31/2999 12/31/2999J8999 00173063535 6/30/2014 3/31/2013J8999 00310020130 12/31/2999 12/31/2999J8999 00378014405 12/31/2999 12/31/2999J8999 00378014491 12/31/2999 12/31/2999J8999 00378027401 12/31/2999 12/31/2999J8999 00378027493 12/31/2999 12/31/2999J8999 00378354725 12/31/2999 12/31/2999J8999 00378354752 12/31/2999 12/31/2999

Page 185: *This document is a compilation of NDC:HCPCS combinations

J8999 00440761330 12/31/2999 12/31/2999J8999 00555060602 12/31/2999 12/31/2999J8999 00555060702 12/31/2999 12/31/2999J8999 00555060704 12/31/2999 12/31/2999J8999 00555088202 12/31/2999 12/31/2999J8999 00591222718 12/31/2013 12/16/2011J8999 00591223218 11/30/2013 2/8/2012J8999 00591223260 11/30/2013 6/21/2012J8999 00591223319 1/31/2014 10/6/2011J8999 00591223330 1/31/2014 10/6/2011J8999 00904357161 12/31/2999 12/31/2999J8999 35356027030 12/31/2999 12/31/2999J8999 49884028901 12/31/2999 12/31/2999J8999 49884029001 12/31/2999 12/31/2999J8999 49884029004 12/31/2999 12/31/2999J8999 49884029005 12/31/2999 12/31/2999J8999 49884072401 12/31/2999 12/31/2999J8999 49884075313 12/31/2999 12/31/2999J8999 49884090738 12/31/2999 12/31/2999J8999 49884090761 12/31/2999 12/31/2999J8999 49884092202 12/31/2999 12/31/2999J8999 49884092204 12/31/2999 12/31/2999J8999 49999098630 12/31/2999 12/31/2999J8999 51079043401 12/31/2999 12/31/2999J8999 51079043420 12/31/2999 12/31/2999J8999 51079043501 12/31/2999 12/31/2999J8999 51079043520 12/31/2999 12/31/2999J8999 54482005301 12/31/2999 12/31/2999J8999 54569376501 12/31/2999 12/31/2999J8999 54569571500 12/31/2999 12/31/2999J8999 54868112600 12/31/2999 6/30/2012J8999 54868112601 12/31/2999 6/30/2012J8999 54868112602 12/31/2999 6/30/2012J8999 54868112603 12/31/2999 6/30/2012J8999 54868112604 12/31/2999 6/30/2012J8999 54868112605 12/31/2999 6/30/2012J8999 54868136600 12/31/2999 6/30/2011J8999 54868136700 12/31/2999 6/30/2011J8999 54868162900 12/31/2999 12/31/2999J8999 54868162901 12/31/2999 6/30/2012J8999 54868162902 12/31/2999 12/31/2999J8999 54868300401 12/31/2999 9/30/2011J8999 54868300402 12/31/2999 12/31/2999J8999 54868300403 12/31/2999 6/30/2011J8999 54868300404 12/31/2999 6/30/2011J8999 54868300405 12/31/2999 6/30/2011J8999 54868309901 12/31/2999 3/31/2011

Page 186: *This document is a compilation of NDC:HCPCS combinations

J8999 54868428700 12/31/2999 12/31/2999J8999 54868428701 12/31/2999 12/31/2999J8999 54868428702 12/31/2999 12/31/2999J8999 54868428703 12/31/2999 12/31/2999J8999 54868428704 12/31/2999 12/31/2999J8999 54868462800 12/31/2999 6/30/2004J8999 54868477300 12/31/2999 12/31/2999J8999 54868477301 12/31/2999 12/31/2999J8999 54868477302 12/31/2999 6/30/2011J8999 54868477303 12/31/2999 12/31/2999J8999 54868500000 12/31/2999 12/31/2999J8999 54868526100 12/31/2999 12/31/2999J8999 54868528200 12/31/2999 12/31/2999J8999 54868528201 12/31/2999 6/30/2011J8999 54868538900 12/31/2999 12/31/2999J8999 54868538901 12/31/2999 12/31/2999J8999 57844052206 12/31/2999 12/31/2999J8999 58016017000 12/31/2999 11/29/2012J8999 58016017030 12/31/2999 11/29/2012J8999 58016017060 12/31/2999 11/29/2012J8999 58016017090 12/31/2999 11/29/2012J8999 58016017099 12/31/2999 11/29/2012J8999 60432012608 12/31/2999 12/31/2999J8999 60432012616 12/31/2999 12/31/2999J8999 60505036801 12/31/2999 12/31/2999J8999 63739016510 12/31/2999 12/31/2999J8999 63739026910 12/31/2999 12/31/2999J8999 66689002001 12/31/2999 12/31/2999J8999 66689002050 12/31/2999 12/31/2999J8999 68084028401 12/31/2999 12/31/2999J8999 68084028411 12/31/2999 12/31/2999J8999 68084032511 12/31/2999 12/31/2999J8999 68084032521 12/31/2999 12/31/2999J8999 68094051862 12/31/2999 12/31/2999J8999 68094052859 12/31/2999 12/31/2999J8999 68094052861 12/31/2999 12/31/2999J8999 68094052862 12/31/2999 12/31/2999J9000 00069017001 12/31/2999 12/31/2999J9000 00069017101 12/31/2999 12/31/2999J9000 00069303020 12/31/2999 12/31/2999J9000 00069303120 12/31/2999 12/31/2999J9000 00069303220 12/31/2999 12/31/2999J9000 00069303320 12/31/2999 12/31/2999J9000 00069303420 12/31/2999 12/31/2999J9000 00069403001 12/31/2999 12/31/2999J9000 00069403101 12/31/2999 12/31/2999J9000 00069403201 12/31/2999 12/31/2999

Page 187: *This document is a compilation of NDC:HCPCS combinations

J9000 00069403301 12/31/2999 12/31/2999J9000 00069403401 12/31/2999 12/31/2999J9000 00703504001 12/31/2999 12/31/2999J9000 00703504303 12/31/2999 12/31/2999J9000 00703504601 12/31/2999 12/31/2999J9000 25021020705 12/31/2999 12/31/2999J9000 25021020725 12/31/2999 12/31/2999J9000 25021020751 12/31/2999 12/31/2999J9000 53150031410 12/31/2999 3/10/2014J9000 53150031501 12/31/2999 12/31/2999J9000 53150031701 12/31/2999 12/31/2999J9000 53150032010 12/31/2999 12/31/2999J9000 55390023110 12/31/2999 12/31/2999J9000 55390023210 12/31/2999 12/31/2999J9000 55390023301 12/31/2999 12/31/2999J9000 55390023610 12/31/2999 12/31/2999J9000 55390023701 12/31/2999 12/31/2999J9000 55390023801 12/31/2999 12/31/2999J9000 55390024110 12/31/2999 4/18/2013J9000 55390024301 12/31/2999 4/18/2013J9000 55390024610 1/31/2013 4/18/2013J9000 55390024701 1/31/2013 4/18/2013J9000 62756082640 12/31/2999 12/31/2999J9000 62756082740 12/31/2999 12/31/2999J9000 63323010161 12/31/2999 12/31/2999J9000 63323088305 12/31/2999 12/31/2999J9000 63323088310 12/31/2999 12/31/2999J9000 63323088330 12/31/2999 12/31/2999J9001 59676096001 12/31/2999 12/31/2999J9001 59676096002 12/31/2999 12/31/2999J9002 47335008250 12/31/2999 12/31/2999J9002 59676096001 12/31/2999 12/31/2999J9002 59676096002 12/31/2999 12/31/2999J9010 58468035703 12/31/2999 9/15/2012J9015 54868559600 12/31/2999 6/30/2011J9015 65483011607 12/31/2999 12/31/2999J9017 63459060010 12/31/2999 12/31/2999J9019 57902024905 12/31/2999 12/31/2999J9020 67386041151 12/31/2999 12/31/2999J9025 00781325394 12/31/2999 12/31/2999J9025 43598030562 12/31/2999 12/31/2999J9025 59572010201 12/31/2999 12/31/2999J9025 67211010201 12/31/2999 5/1/2009J9027 58468010001 12/31/2999 12/31/2999J9027 58468010002 12/31/2999 12/31/2999J9031 00052060202 12/31/2999 12/31/2999J9031 00052060302 12/31/2999 12/31/2999

Page 188: *This document is a compilation of NDC:HCPCS combinations

J9031 49281088001 12/31/2999 12/31/2999J9031 49281088003 12/31/2999 12/31/2999J9033 63459039008 12/31/2999 12/31/2999J9033 63459039120 12/31/2999 12/31/2999J9035 50242006001 12/31/2999 12/31/2999J9035 50242006101 12/31/2999 12/31/2999J9040 00703315401 12/31/2999 12/31/2999J9040 00703315501 12/31/2999 12/31/2999J9040 55390000501 12/31/2999 5/2/2011J9040 55390000601 12/31/2999 5/2/2011J9040 61703032322 12/31/2999 12/31/2999J9040 61703033218 12/31/2999 12/31/2999J9040 63323013610 12/31/2999 12/31/2999J9040 63323013720 12/31/2999 12/31/2999J9041 63020004901 12/31/2999 12/31/2999J9042 51144005001 12/31/2999 12/31/2999J9043 00024582411 12/31/2999 12/31/2999J9045 00409112910 12/31/2999 7/1/2008J9045 00409112911 12/31/2999 10/1/2008J9045 00409112912 12/31/2999 10/1/2008J9045 00703324411 12/31/2999 12/31/2999J9045 00703324811 12/31/2999 12/31/2999J9045 00703324911 12/31/2999 12/31/2999J9045 00703424401 12/31/2999 12/31/2999J9045 00703424601 12/31/2999 12/31/2999J9045 00703424801 12/31/2999 12/31/2999J9045 10139006005 12/31/2999 9/23/2011J9045 10139006015 12/31/2999 9/23/2011J9045 10139006045 12/31/2999 9/23/2011J9045 15210006112 12/31/2999 10/2/2008J9045 15210006312 12/31/2999 7/21/2008J9045 15210006612 12/31/2999 8/26/2008J9045 15210006712 12/31/2999 6/20/2008J9045 25021020205 12/31/2999 12/31/2999J9045 25021020215 12/31/2999 12/31/2999J9045 25021020245 12/31/2999 12/31/2999J9045 25021020251 12/31/2999 12/31/2999J9045 50111096776 12/31/2999 10/15/2009J9045 55390015001 12/31/2999 5/2/2011J9045 55390015101 12/31/2999 5/2/2011J9045 55390015201 12/31/2999 5/2/2011J9045 55390015301 12/31/2999 5/2/2011J9045 55390015401 12/31/2999 5/2/2011J9045 55390015501 12/31/2999 5/2/2011J9045 55390015601 12/31/2999 5/2/2011J9045 61703033918 12/31/2999 12/31/2999J9045 61703033922 12/31/2999 12/31/2999

Page 189: *This document is a compilation of NDC:HCPCS combinations

J9045 61703033950 12/31/2999 12/31/2999J9045 61703033956 12/31/2999 12/31/2999J9045 61703033961 12/31/2999 7/19/2011J9045 61703033962 12/31/2999 12/31/2999J9045 61703036018 12/31/2999 12/31/2999J9045 61703036022 12/31/2999 12/31/2999J9045 61703036050 12/31/2999 12/31/2999J9045 63323016610 12/31/2999 12/11/2009J9045 63323016721 12/31/2999 12/31/2999J9045 63323016800 12/31/2999 12/11/2009J9045 63323017205 12/31/2999 12/31/2999J9045 63323017215 12/31/2999 12/31/2999J9045 63323017245 12/31/2999 12/31/2999J9045 63323017260 12/31/2999 12/31/2999J9045 66758004701 12/31/2999 12/29/2011J9045 66758004702 12/31/2999 12/29/2011J9045 66758004703 12/31/2999 12/29/2011J9045 66758004704 12/31/2999 12/31/2999J9047 76075010101 12/31/2999 12/31/2999J9050 00015301260 12/31/2999 12/31/2999J9050 23155026141 12/31/2999 12/31/2999J9055 66733094823 12/31/2999 12/31/2999J9055 66733095823 12/31/2999 12/31/2999J9060 00069008101 12/31/2999 12/31/2999J9060 00069008407 12/31/2999 12/31/2999J9060 00703574711 12/31/2999 12/31/2999J9060 00703574811 12/31/2999 12/31/2999J9060 10019091001 12/31/2999 12/22/2005J9060 44567050901 12/31/2999 12/31/2999J9060 44567051001 12/31/2999 12/31/2999J9060 55390009901 12/31/2999 5/2/2011J9060 55390011250 12/31/2999 5/2/2011J9060 55390011299 12/31/2999 5/2/2011J9060 55390018701 12/31/2999 5/2/2011J9060 55390041450 12/31/2999 5/2/2011J9060 55390041499 12/31/2999 5/2/2011J9060 63323010351 12/31/2999 12/31/2999J9060 63323010364 12/31/2999 12/31/2999J9060 63323010365 12/31/2999 12/31/2999J9065 00069008618 12/31/2999 12/31/2999J9065 00069020101 12/31/2999 12/31/2999J9065 55390011501 12/31/2999 4/18/2013J9065 55390012401 12/31/2999 12/31/2999J9065 63323014010 12/31/2999 12/31/2999J9070 10019095501 12/31/2999 12/31/2999J9070 10019095550 12/31/2999 12/31/2999J9070 10019095601 12/31/2999 12/31/2999

Page 190: *This document is a compilation of NDC:HCPCS combinations

J9070 10019095616 12/31/2999 12/31/2999J9070 10019095701 12/31/2999 12/31/2999J9070 10019095711 12/31/2999 12/31/2999J9098 57665033101 12/31/2999 12/31/2999J9100 00069015202 12/31/2999 12/31/2999J9100 00069015302 12/31/2999 12/31/2999J9100 00069015401 12/31/2999 12/31/2999J9100 00069015501 12/31/2999 12/31/2999J9100 55390013110 12/31/2999 12/31/2999J9100 55390013301 12/31/2999 12/31/2999J9100 55390013401 12/31/2999 5/2/2011J9100 55390080610 12/31/2999 4/18/2013J9100 55390080710 12/31/2999 12/31/2999J9100 55390080801 12/31/2999 4/18/2013J9100 55390080901 12/31/2999 5/2/2011J9100 61703030346 12/31/2999 12/31/2999J9100 61703030436 12/31/2999 12/31/2999J9100 61703030538 12/31/2999 12/31/2999J9100 61703031922 12/31/2999 12/31/2999J9100 63323012020 12/31/2999 12/31/2999J9120 55292081155 12/31/2999 12/31/2999J9120 55390033701 12/31/2999 12/31/2999J9120 67386081155 12/31/2999 12/31/2999J9130 00703507501 12/31/2999 12/31/2999J9130 00703507503 12/31/2999 12/31/2999J9130 61703032722 12/31/2999 12/31/2999J9130 63323012710 12/31/2999 12/31/2999J9130 63323012812 12/31/2999 11/21/2007J9130 63323012820 12/31/2999 12/31/2999J9150 00703503203 12/31/2999 11/27/2012J9150 00703523313 12/31/2999 12/31/2999J9150 00703523393 12/31/2999 12/31/2999J9150 55390010801 12/31/2999 12/31/2999J9150 55390010810 12/31/2999 12/31/2999J9150 55390014210 10/31/2012 4/18/2013J9150 55390028110 12/31/2999 12/31/2999J9150 55390080510 12/31/2999 4/18/2013J9150 63323011908 12/31/2999 12/31/2999J9150 63323012404 12/31/2999 5/10/2007J9151 61958030101 12/31/2999 7/1/2011J9155 55566830101 12/31/2999 12/31/2999J9155 55566830102 12/31/2999 12/31/2999J9155 55566830301 12/31/2999 12/31/2999J9155 55566840101 12/31/2999 12/31/2999J9155 55566840102 12/31/2999 12/31/2999J9155 55566840301 12/31/2999 12/31/2999J9160 62856060301 12/31/2999 12/31/2999

Page 191: *This document is a compilation of NDC:HCPCS combinations

J9171 00075800180 6/30/2013 6/30/2013J9171 00075800301 12/31/2999 12/31/2999J9171 00075800404 12/31/2999 12/31/2999J9171 00409020102 12/31/2999 12/31/2999J9171 00409020110 12/31/2999 12/31/2999J9171 00409020120 12/31/2999 12/31/2999J9171 00409020125 12/31/2999 12/31/2999J9171 00409020126 12/31/2999 12/31/2999J9171 00409020127 12/31/2999 12/31/2999J9171 00955102001 12/31/2999 12/31/2999J9171 00955102104 12/31/2999 12/31/2999J9171 16729012049 12/31/2999 12/31/2999J9171 16729022850 12/31/2999 12/31/2999J9171 16729023163 12/31/2999 12/31/2999J9171 16729023164 12/31/2999 12/31/2999J9171 16729023165 12/31/2999 12/31/2999J9171 16729026763 12/31/2999 12/31/2999J9171 16729026765 12/31/2999 12/31/2999J9171 25021022201 12/31/2999 12/31/2999J9171 25021022204 12/31/2999 12/31/2999J9171 25021022207 12/31/2999 12/31/2999J9171 47335028541 12/31/2999 12/31/2999J9171 47335028641 12/31/2999 12/31/2999J9171 66758005001 12/31/2999 12/31/2999J9171 66758005002 12/31/2999 12/31/2999J9171 66758005003 12/31/2999 12/31/2999J9175 67871000710 12/31/2999 6/4/2013J9178 00009509101 12/31/2999 12/31/2999J9178 00009509301 12/31/2999 12/31/2999J9178 00591346983 12/31/2999 10/23/2007J9178 00591347057 12/31/2999 10/23/2007J9178 00703306711 12/31/2999 12/31/2999J9178 00703306911 12/31/2999 12/31/2999J9178 10518010410 12/31/2999 8/21/2009J9178 10518010411 12/31/2999 2/1/2013J9178 25021020325 12/31/2999 12/31/2999J9178 25021020351 12/31/2999 12/31/2999J9178 53150024701 12/31/2999 3/1/2014J9178 53150025001 12/31/2999 12/31/2999J9178 55390020701 12/31/2999 5/2/2011J9178 55390020801 12/31/2999 5/2/2011J9178 61703034735 12/31/2999 12/31/2999J9178 61703034859 12/31/2999 12/31/2999J9178 61703035901 12/31/2999 12/31/2999J9178 61703035902 12/31/2999 12/31/2999J9178 61703035959 12/31/2999 12/31/2999J9178 61703035992 12/31/2999 11/30/2009

Page 192: *This document is a compilation of NDC:HCPCS combinations

J9178 61703035993 12/31/2999 12/31/2999J9178 63323015100 12/31/2999 12/31/2999J9178 63323015105 12/31/2999 9/11/2009J9178 63323015125 12/31/2999 12/31/2999J9178 63323015175 12/31/2999 9/11/2009J9178 66758004201 12/31/2999 12/31/2999J9178 66758004202 12/31/2999 12/31/2999J9179 62856038901 12/31/2999 12/31/2999J9181 00015340420 12/31/2999 12/31/2999J9181 00703564301 12/31/2999 11/27/2012J9181 00703565301 12/31/2999 12/31/2999J9181 00703565601 12/31/2999 12/31/2999J9181 00703565691 12/31/2999 12/31/2999J9181 00703565701 12/31/2999 12/31/2999J9181 00703565791 12/31/2999 12/31/2999J9181 16729011431 12/31/2999 12/31/2999J9181 55390029101 12/31/2999 12/31/2999J9181 55390029201 12/31/2999 12/31/2999J9181 55390029301 12/31/2999 12/31/2999J9181 55390049101 12/31/2999 4/18/2013J9181 55390049201 12/31/2999 4/18/2013J9181 55390049301 12/31/2999 4/18/2013J9181 63323010405 12/31/2999 12/31/2999J9181 63323010425 12/31/2999 12/31/2999J9181 63323010450 12/31/2999 12/31/2999J9181 63323010465 12/31/2999 5/10/2007J9185 00703485211 12/31/2999 12/31/2999J9185 00703585401 12/31/2999 12/31/2999J9185 25021020505 12/31/2999 12/31/2999J9185 50419051106 6/30/2013 6/30/2013J9185 61703034418 12/31/2999 12/31/2999J9185 63323019002 12/31/2999 12/3/2008J9185 63323019202 12/31/2999 12/31/2999J9185 63323019606 12/31/2999 12/31/2999J9185 66758004601 12/31/2999 12/31/2999J9185 67457023802 12/31/2999 12/31/2999J9190 00703301513 12/31/2999 12/31/2999J9190 00703301812 12/31/2999 12/31/2999J9190 00703301912 12/31/2999 12/31/2999J9190 10139006301 12/31/2999 12/31/2999J9190 10139006310 6/30/2014 12/31/2999J9190 10139006311 12/31/2999 12/31/2999J9190 10139006312 12/31/2999 12/31/2999J9190 10139006320 4/30/2014 12/31/2999J9190 10139006350 12/31/2999 12/31/2999J9190 63323011710 12/31/2999 12/31/2999J9190 63323011720 12/31/2999 12/31/2999

Page 193: *This document is a compilation of NDC:HCPCS combinations

J9190 63323011751 12/31/2999 12/31/2999J9190 63323011761 12/31/2999 12/31/2999J9190 66758004401 12/31/2999 6/22/2011J9190 66758004403 12/31/2999 6/22/2011J9200 55390013501 12/31/2999 12/31/2999J9200 63323014507 12/31/2999 12/31/2999J9201 00002750101 12/31/2999 12/31/2999J9201 00002750201 12/31/2999 12/31/2999J9201 00024279210 12/31/2999 12/31/2999J9201 00052060302 12/31/2999 12/31/2999J9201 00069385710 12/31/2999 12/31/2999J9201 00069385810 12/31/2999 12/31/2999J9201 00069385910 12/31/2999 12/31/2999J9201 00409018101 12/31/2999 12/31/2999J9201 00409018125 12/31/2999 12/31/2999J9201 00409018201 12/31/2999 12/31/2999J9201 00409018225 12/31/2999 12/31/2999J9201 00409018301 12/31/2999 12/31/2999J9201 00409018325 12/31/2999 12/31/2999J9201 00409018501 12/31/2999 12/31/2999J9201 00409018601 12/31/2999 12/31/2999J9201 00409018701 12/31/2999 12/31/2999J9201 00591356279 6/30/2013 7/10/2012J9201 00591356355 9/30/2013 12/31/2999J9201 00703577501 12/31/2999 12/31/2999J9201 00703577801 12/31/2999 12/31/2999J9201 00781328275 5/31/2014 12/31/2999J9201 00781328379 12/31/2999 12/31/2999J9201 16729009203 12/31/2999 12/31/2999J9201 16729011711 12/31/2999 12/31/2999J9201 16729011838 12/31/2999 12/31/2999J9201 23155021331 12/31/2999 12/31/2999J9201 23155021431 12/31/2999 12/31/2999J9201 25021020810 12/31/2999 12/31/2999J9201 25021020950 12/31/2999 12/31/2999J9201 47335015340 12/31/2999 12/31/2999J9201 47335015440 12/31/2999 12/31/2999J9201 55111068607 12/31/2999 12/31/2999J9201 55111068725 12/31/2999 12/31/2999J9201 55390039110 12/31/2999 12/31/2999J9201 55390039150 12/31/2999 12/31/2999J9201 63323010210 12/31/2999 12/4/2012J9201 63323010213 12/31/2999 12/31/2999J9201 63323012550 12/31/2999 6/27/2012J9201 63323012553 12/31/2999 12/31/2999J9201 63323012600 12/31/2999 12/31/2999J9202 00310095036 12/31/2999 12/31/2999

Page 194: *This document is a compilation of NDC:HCPCS combinations

J9202 00310095130 12/31/2999 12/31/2999J9206 00009111101 12/31/2999 12/31/2999J9206 00009111102 12/31/2999 12/31/2999J9206 00009752901 9/1/2013 11/29/2010J9206 00009752902 6/1/2013 11/29/2010J9206 00009752903 12/31/2999 12/31/2999J9206 00009752904 12/31/2999 12/31/2999J9206 00009752905 12/31/2999 12/31/2999J9206 00143970101 12/31/2999 12/31/2999J9206 00143970201 12/31/2999 12/31/2999J9206 00703443211 12/31/2999 12/31/2999J9206 00703443411 12/31/2999 12/31/2999J9206 10019093401 12/31/2999 12/31/2999J9206 10019093402 12/31/2999 12/31/2999J9206 10019093417 12/31/2999 12/31/2999J9206 10019093479 12/31/2999 12/31/2999J9206 10518010310 12/31/2999 3/11/2009J9206 18111000202 12/31/2999 11/30/2012J9206 18111000203 12/31/2999 11/30/2012J9206 23155017931 12/31/2999 12/31/2999J9206 23155017932 12/31/2999 12/31/2999J9206 25021020002 12/31/2999 7/5/2011J9206 25021020005 12/31/2999 7/5/2011J9206 25021021402 12/31/2999 12/31/2999J9206 25021021405 12/31/2999 12/31/2999J9206 55390029501 12/31/2999 5/2/2011J9206 55390029601 12/31/2999 5/2/2011J9206 59762752902 1/1/2013 12/31/2999J9206 61703034909 12/31/2999 12/31/2999J9206 61703034916 12/31/2999 12/31/2999J9206 61703034936 12/31/2999 12/31/2999J9206 63323019302 12/31/2999 12/31/2999J9206 63323019305 12/31/2999 12/31/2999J9206 66758004801 12/31/2999 12/31/2999J9206 66758004802 12/31/2999 12/31/2999J9207 00015191012 12/31/2999 12/31/2999J9207 00015191113 12/31/2999 12/31/2999J9208 00069449522 12/31/2999 12/31/2999J9208 00069449622 12/31/2999 12/31/2999J9208 00338399101 12/31/2999 12/31/2999J9208 00338399301 12/31/2999 12/31/2999J9208 00703342711 12/31/2999 12/31/2999J9208 00703342911 12/31/2999 12/31/2999J9208 10019092501 12/31/2999 12/31/2999J9208 10019092582 12/31/2999 12/31/2999J9208 10019092602 12/31/2999 12/31/2999J9208 10019092616 12/31/2999 12/31/2999

Page 195: *This document is a compilation of NDC:HCPCS combinations

J9208 63323014210 12/31/2999 12/31/2999J9208 63323014212 12/31/2999 12/31/2999J9208 63323017420 12/31/2999 12/31/2999J9208 63323017460 12/31/2999 12/31/2999J9209 00338130501 12/31/2999 12/31/2999J9209 00338130503 12/31/2999 12/31/2999J9209 00703480503 12/31/2999 12/31/2999J9209 10019095301 12/31/2999 12/31/2999J9209 10019095302 12/31/2999 12/31/2999J9209 25021020110 12/31/2999 12/31/2999J9209 25021020111 12/31/2999 12/31/2999J9209 25021020166 12/31/2999 12/31/2999J9209 25021020167 12/31/2999 12/31/2999J9209 25021020168 12/31/2999 12/31/2999J9209 25021020169 12/31/2999 12/31/2999J9209 55390004501 12/31/2999 12/31/2999J9209 55390034701 12/31/2999 4/18/2013J9209 63323073310 12/31/2999 12/31/2999J9209 63323073311 12/31/2999 12/31/2999J9209 63323073312 12/31/2999 11/21/2007J9209 67457014810 12/31/2999 12/31/2999J9211 00013257691 12/31/2999 12/31/2999J9211 00013258691 12/31/2999 12/31/2999J9211 00013259691 12/31/2999 12/31/2999J9211 00703415411 12/31/2999 12/31/2999J9211 00703415511 12/31/2999 12/31/2999J9211 00703415591 1/31/2013 5/5/2011J9211 00703415611 12/31/2999 12/31/2999J9211 00703415691 1/31/2013 7/12/2011J9211 55390021501 12/31/2999 5/2/2011J9211 55390021701 12/31/2999 5/2/2011J9211 63323019405 12/31/2999 12/31/2999J9211 63323019410 12/31/2999 12/31/2999J9211 63323019420 12/31/2999 12/31/2999J9212 66435020115 12/31/2999 12/31/2999J9212 66435020196 12/31/2999 12/31/2999J9214 00085053901 12/31/2999 12/31/2999J9214 00085057102 12/31/2999 12/31/2999J9214 00085111001 12/31/2999 12/31/2999J9214 00085113301 12/31/2999 12/31/2999J9214 00085116801 12/31/2999 12/31/2999J9214 54868334100 12/31/2999 6/30/2011J9215 54746000101 12/31/2999 12/31/2999J9216 64116001101 12/31/2999 12/31/2999J9216 64116001112 12/31/2999 12/31/2999J9217 00024022205 12/31/2999 12/31/2999J9217 00024060545 12/31/2999 12/31/2999

Page 196: *This document is a compilation of NDC:HCPCS combinations

J9217 00024061030 12/31/2999 12/31/2999J9217 00024079375 12/31/2999 12/31/2999J9217 00074210803 12/31/2999 12/31/2999J9217 00074228203 12/31/2999 12/31/2999J9217 00074244003 12/31/2999 12/31/2999J9217 00074334603 12/31/2999 12/31/2999J9217 00074347303 12/31/2999 12/31/2999J9217 00074364103 12/31/2999 12/31/2999J9217 00074364203 12/31/2999 12/31/2999J9217 00074366303 12/31/2999 12/31/2999J9217 00074368303 12/31/2999 12/31/2999J9217 54868556800 12/31/2999 6/30/2011J9218 00300361228 12/31/2999 7/24/2009J9218 00703401418 12/31/2999 12/31/2999J9218 00781400332 12/31/2999 12/31/2999J9218 41616093640 12/31/2999 12/31/2999J9219 00026971101 12/31/2999 6/30/2008J9225 67979000201 12/31/2999 12/31/2999J9225 67979050001 12/31/2999 12/31/2999J9226 67979000201 12/31/2999 12/31/2999J9226 67979050001 12/31/2999 12/31/2999J9228 00003232711 12/31/2999 12/31/2999J9228 00003232822 12/31/2999 12/31/2999J9230 55292091151 12/31/2999 12/31/2999J9230 67386091151 12/31/2999 12/31/2999J9245 52609300100 12/31/2999 12/31/2999J9245 67457019501 12/31/2999 12/31/2999J9245 67457021501 12/31/2999 12/31/2999J9250 00069020410 12/31/2999 12/31/2999J9250 00703367103 12/31/2999 12/31/2999J9250 00703367193 12/31/2999 12/31/2999J9250 00703367301 12/31/2999 12/31/2999J9250 00703367501 12/31/2999 12/31/2999J9250 00703367591 12/31/2999 12/31/2999J9250 00703367801 12/31/2999 12/31/2999J9250 10139006202 12/31/2999 2/15/2013J9250 10139006210 12/31/2999 12/31/2999J9250 10139006240 12/31/2999 2/7/2013J9250 55390003110 12/31/2999 12/31/2999J9250 55390003210 12/31/2999 12/31/2999J9250 55390003310 12/31/2999 12/31/2999J9250 55390003410 12/31/2999 12/31/2999J9250 55390014301 12/31/2999 12/31/2999J9250 61703035038 12/31/2999 12/31/2999J9250 61703040841 12/31/2999 12/31/2999J9250 63323012102 12/31/2999 12/31/2999J9250 63323012104 12/31/2999 3/22/2012

Page 197: *This document is a compilation of NDC:HCPCS combinations

J9250 63323012108 12/31/2999 12/31/2999J9250 63323012110 12/31/2999 12/31/2999J9250 63323012140 12/31/2999 12/31/2999J9250 63323012250 12/31/2999 12/31/2999J9250 63323012302 12/31/2999 12/31/2999J9250 63323012310 12/31/2999 12/31/2999J9250 66758004002 12/31/2999 10/27/2010J9250 66758004008 12/31/2999 10/27/2010J9250 66758004101 12/31/2999 12/31/2999J9250 67457022102 12/31/2999 12/31/2999J9250 67457022110 12/31/2999 12/31/2999J9250 67457022140 12/31/2999 12/31/2999J9260 00069014602 12/31/2999 12/31/2999J9260 00069014702 12/31/2999 12/31/2999J9260 00069014801 12/31/2999 12/31/2999J9260 00069014901 12/31/2999 12/31/2999J9260 00069018102 12/31/2999 12/31/2999J9260 00069020410 12/31/2999 12/31/2999J9260 00703367193 12/31/2999 12/31/2999J9260 00703367591 12/31/2999 12/31/2999J9260 10139006202 12/31/2999 2/15/2013J9260 10139006210 12/31/2999 12/31/2999J9260 10139006240 12/31/2999 2/7/2013J9260 55390003110 12/31/2999 12/31/2999J9260 55390003210 12/31/2999 12/31/2999J9260 55390003310 12/31/2999 12/31/2999J9260 55390003410 12/31/2999 12/31/2999J9260 55390014301 12/31/2999 12/31/2999J9260 61703035038 12/31/2999 12/31/2999J9260 61703040841 12/31/2999 12/31/2999J9260 63323012102 12/31/2999 12/31/2999J9260 63323012104 12/31/2999 3/22/2012J9260 63323012108 12/31/2999 12/31/2999J9260 63323012110 12/31/2999 12/31/2999J9260 63323012140 12/31/2999 12/31/2999J9260 63323012250 12/31/2999 12/31/2999J9260 63323012302 12/31/2999 12/31/2999J9260 63323012310 12/31/2999 12/31/2999J9260 66758004002 12/31/2999 10/27/2010J9260 66758004008 12/31/2999 10/27/2010J9260 66758004101 12/31/2999 12/31/2999J9260 67457022102 12/31/2999 12/31/2999J9260 67457022110 12/31/2999 12/31/2999J9260 67457022140 12/31/2999 12/31/2999J9261 00007440101 12/31/2999 12/31/2999J9261 00007440106 12/31/2999 12/31/2999J9263 00024059010 12/31/2999 12/31/2999

Page 198: *This document is a compilation of NDC:HCPCS combinations

J9263 00024059120 12/31/2999 12/31/2999J9263 00024059240 12/31/2999 12/31/2999J9263 00069006701 12/31/2999 12/31/2999J9263 00069007001 12/31/2999 12/31/2999J9263 00069007401 12/31/2999 12/31/2999J9263 00069101001 12/31/2999 12/31/2999J9263 00703398501 12/31/2999 12/31/2999J9263 00703398601 12/31/2999 12/31/2999J9263 25021021120 12/31/2999 12/31/2999J9263 25021021250 12/31/2999 12/31/2999J9263 41616017640 12/31/2999 12/31/2999J9263 41616017840 12/31/2999 12/31/2999J9263 47335017640 12/31/2999 12/31/2999J9263 47335017840 12/31/2999 12/31/2999J9263 61703036318 12/31/2999 12/31/2999J9263 61703036322 12/31/2999 12/31/2999J9263 63323017530 12/31/2999 12/31/2999J9263 63323017650 12/31/2999 12/31/2999J9263 63323065010 12/31/2999 12/31/2999J9263 63323065017 12/31/2999 12/31/2999J9263 63323065020 12/31/2999 12/31/2999J9263 63323065027 12/31/2999 12/31/2999J9264 68817013450 12/31/2999 12/31/2999J9265 00069007601 12/31/2999 12/31/2999J9265 00069007801 12/31/2999 12/31/2999J9265 00069007901 12/31/2999 12/31/2999J9265 00172375494 12/31/2999 12/31/2999J9265 00555198414 12/31/2999 6/30/2009J9265 00555198514 12/31/2999 6/30/2009J9265 00703476401 12/31/2999 12/31/2999J9265 00703476601 12/31/2999 12/31/2999J9265 00703476701 12/31/2999 12/31/2999J9265 00703476801 12/31/2999 12/31/2999J9265 25021021305 12/31/2999 12/31/2999J9265 25021021317 12/31/2999 12/31/2999J9265 25021021350 12/31/2999 12/31/2999J9265 55390011405 12/31/2999 12/31/2999J9265 55390011420 12/31/2999 12/31/2999J9265 55390011450 12/31/2999 12/31/2999J9265 55390030405 11/30/2012 4/18/2013J9265 55390030420 4/30/2013 4/18/2013J9265 55390030450 4/30/2013 4/18/2013J9265 61703034209 12/31/2999 12/31/2999J9265 61703034222 12/31/2999 12/31/2999J9265 61703034250 12/31/2999 12/31/2999J9265 63323076305 12/31/2999 12/31/2999J9265 63323076316 12/31/2999 12/31/2999

Page 199: *This document is a compilation of NDC:HCPCS combinations

J9265 63323076350 12/31/2999 12/31/2999J9265 66758004301 12/31/2999 12/31/2999J9265 66758004302 12/31/2999 12/31/2999J9265 66758004303 12/31/2999 12/31/2999J9266 54482030101 12/31/2999 12/31/2999J9266 57665000202 12/6/2011 10/1/2011J9268 00409080101 12/31/2999 12/31/2999J9268 55390024401 12/31/2999 12/31/2999J9280 16729010811 12/31/2999 12/31/2999J9280 16729011505 12/31/2999 12/31/2999J9280 16729011638 12/31/2999 12/31/2999J9280 16729024605 12/31/2999 12/31/2999J9280 16729024711 12/31/2999 12/31/2999J9280 16729024838 12/31/2999 12/31/2999J9280 55390025101 12/31/2999 12/31/2999J9280 55390025201 12/31/2999 12/31/2999J9280 55390025301 12/31/2999 12/31/2999J9280 55390045101 12/31/2999 4/18/2013J9280 55390045201 12/31/2999 4/18/2013J9280 55390045301 12/31/2999 4/18/2013J9293 00703468001 12/31/2999 12/31/2999J9293 00703468501 12/31/2999 12/31/2999J9293 00703468601 12/31/2999 12/31/2999J9293 10518010511 12/31/2999 2/1/2013J9293 10518010512 12/31/2999 2/1/2013J9293 15210040335 12/31/2999 6/2/2009J9293 15210040336 12/31/2999 6/2/2009J9293 15210040337 12/31/2999 7/1/2008J9293 44087152001 11/30/2013 6/8/2011J9293 55390008301 12/31/2999 5/2/2011J9293 55390008401 12/31/2999 5/2/2011J9293 55390008501 12/31/2999 5/2/2011J9293 61703034318 12/31/2999 12/31/2999J9293 61703034365 12/31/2999 12/31/2999J9293 61703034366 12/31/2999 12/31/2999J9293 63323013210 12/31/2999 12/31/2999J9293 63323013212 12/31/2999 12/31/2999J9293 63323013215 12/31/2999 12/31/2999J9300 00008451001 12/31/2999 6/21/2010J9302 00173082101 12/31/2999 12/31/2999J9302 00173082133 12/31/2999 12/31/2999J9303 55513095401 12/31/2999 12/31/2999J9303 55513095601 12/31/2999 12/31/2999J9305 00002762301 12/31/2999 12/31/2999J9305 00002764001 12/31/2999 12/31/2999J9306 50242014501 12/31/2999 12/31/2999J9307 48818000101 12/31/2999 12/31/2999

Page 200: *This document is a compilation of NDC:HCPCS combinations

J9307 48818000102 12/31/2999 12/31/2999J9310 50242005121 12/31/2999 12/31/2999J9310 50242005306 12/31/2999 12/31/2999J9315 46026098301 12/31/2999 8/20/2010J9315 59572098301 12/31/2999 12/31/2999J9320 00703463601 12/31/2999 12/31/2999J9328 00085138101 12/31/2999 12/31/2999J9330 00008117901 12/31/2999 12/31/2999J9340 55390003010 12/31/2999 12/31/2999J9351 00007420101 12/31/2999 12/31/2999J9351 00069007501 12/31/2999 12/31/2999J9351 00409030201 12/31/2999 12/31/2999J9351 00703471401 12/31/2999 12/31/2999J9351 16729015131 12/31/2999 12/31/2999J9351 25021020606 12/31/2999 12/31/2999J9351 25021020661 12/31/2999 12/31/2999J9351 25021082406 12/31/2999 12/31/2999J9351 55390037010 12/31/2999 12/31/2999J9351 62756002340 12/31/2999 12/31/2999J9351 63323076210 12/31/2999 12/31/2999J9351 63323076217 12/31/2999 12/31/2999J9351 63323076294 12/31/2999 12/31/2999J9354 50242008701 12/31/2999 12/31/2999J9354 50242008801 12/31/2999 12/31/2999J9355 50242005656 12/31/2999 12/31/2999J9355 50242013468 12/31/2999 12/31/2999J9357 67979000101 12/31/2999 12/31/2999J9357 67979000102 12/31/2999 2/2/2011J9360 55390009110 12/31/2999 12/31/2999J9360 63323027810 12/31/2999 12/31/2999J9370 00703440211 12/31/2999 12/31/2999J9370 00703441211 12/31/2999 12/31/2999J9370 61703030906 12/31/2999 12/31/2999J9370 61703030916 12/31/2999 12/31/2999J9370 61703030925 12/31/2999 12/31/2999J9371 20536032201 12/31/2999 12/31/2999J9390 00069009901 12/31/2999 12/31/2999J9390 00069010303 12/31/2999 12/31/2999J9390 00069020510 12/31/2999 12/31/2999J9390 00069020550 12/31/2999 12/31/2999J9390 00703418201 12/31/2999 12/31/2999J9390 00703418281 12/31/2999 3/10/2011J9390 00703418291 5/31/2012 4/3/2013J9390 00703418301 12/31/2999 12/31/2999J9390 00703418381 12/31/2999 3/10/2011J9390 00703418391 12/31/2012 4/3/2013J9390 25021020401 12/31/2999 12/31/2999

Page 201: *This document is a compilation of NDC:HCPCS combinations

J9390 25021020405 12/31/2999 12/31/2999J9390 55390006901 12/31/2999 12/31/2999J9390 55390007001 12/31/2999 12/31/2999J9390 61703034106 12/31/2999 12/31/2999J9390 61703034109 12/31/2999 12/31/2999J9390 63323014801 12/31/2999 12/31/2999J9390 63323014805 12/31/2999 12/31/2999J9390 64370021001 6/1/2014 1/1/2010J9390 64370025001 6/1/2014 1/1/2010J9390 64370053201 12/31/2999 12/31/2999J9390 64370053202 12/31/2999 12/31/2999J9390 66758004501 12/31/2999 3/9/2012J9390 66758004502 12/31/2999 12/31/2999J9395 00310072010 12/31/2999 12/31/2999J9395 00310072050 12/31/2999 1/13/2011J9400 00024584001 12/31/2999 12/31/2999J9400 00024584101 12/31/2999 12/31/2999J9600 58914015575 12/31/2999 3/31/2011J9999 00002759701 12/31/2999 12/31/2999J9999 00002763511 12/31/2999 12/31/2999J9999 00002763611 12/31/2999 12/31/2999J9999 00002763711 12/31/2999 12/31/2999J9999 00003223011 12/31/2999 12/31/2999J9999 00003224011 12/31/2999 12/31/2999J9999 00003232711 12/31/2999 12/31/2999J9999 00003256016 12/31/2999 12/31/2999J9999 00003257016 12/31/2999 12/31/2999J9999 00004035009 12/31/2999 12/31/2999J9999 00004691106 1/31/2013 1/31/2013J9999 00008092351 12/31/2999 12/31/2999J9999 00008092355 12/31/2999 12/31/2999J9999 00008117901 12/31/2999 12/31/2999J9999 00008117905 12/31/2999 12/31/2999J9999 00009023301 12/31/2999 12/31/2999J9999 00009023344 4/1/2013 1/1/2011J9999 00009043624 12/31/2999 2/26/2013J9999 00009072809 12/31/2999 12/31/2999J9999 00009077526 12/31/2999 12/31/2999J9999 00009087026 12/31/2999 12/31/2999J9999 00009090211 12/31/2999 12/31/2999J9999 00009090218 12/31/2999 12/31/2999J9999 00009312403 12/31/2999 12/31/2999J9999 00009337502 12/31/2999 12/31/2999J9999 00009338102 12/31/2999 12/31/2999J9999 00009338201 12/31/2999 12/31/2999J9999 00009338202 12/31/2999 12/31/2999J9999 00009344703 12/31/2999 12/31/2999

Page 202: *This document is a compilation of NDC:HCPCS combinations

J9999 00015191012 12/31/2999 12/31/2999J9999 00015191113 12/31/2999 12/31/2999J9999 00023334807 12/31/2999 12/31/2999J9999 00024582411 12/31/2999 12/31/2999J9999 00024584001 12/31/2999 12/31/2999J9999 00024584101 12/31/2999 12/31/2999J9999 00029657126 12/31/2999 12/31/2999J9999 00029657131 12/31/2999 12/31/2999J9999 00029657921 12/31/2999 12/31/2999J9999 00065054301 12/31/2999 12/31/2999J9999 00068059701 12/31/2999 12/31/2999J9999 00069000601 12/31/2999 12/31/2999J9999 00069000603 12/31/2999 12/31/2999J9999 00069009303 12/31/2999 12/31/2999J9999 00069009402 12/31/2999 12/31/2999J9999 00069010404 12/31/2999 12/31/2999J9999 00069010503 12/31/2999 12/31/2999J9999 00069010601 12/31/2999 12/31/2999J9999 00069010805 12/31/2999 12/31/2999J9999 00069011201 12/31/2999 12/31/2999J9999 00069012102 12/31/2999 12/31/2999J9999 00069012502 12/31/2999 12/31/2999J9999 00069012602 12/31/2999 12/31/2999J9999 00069014101 12/31/2999 1/30/2013J9999 00074114315 12/31/2999 7/19/2011J9999 00074156410 12/31/2999 12/31/2999J9999 00074229111 12/31/2999 5/2/2011J9999 00074400001 12/31/2999 7/19/2011J9999 00078040001 12/31/2999 12/31/2999J9999 00078041420 12/31/2999 12/31/2999J9999 00078041520 12/31/2999 12/31/2999J9999 00078041720 12/31/2999 12/31/2999J9999 00078058261 12/31/2999 12/31/2999J9999 00143966010 12/31/2999 12/31/2999J9999 00143967910 12/31/2999 12/31/2999J9999 00143968025 12/31/2999 12/31/2999J9999 00143968125 12/31/2999 12/31/2999J9999 00143968225 12/31/2999 12/31/2999J9999 00143968310 12/31/2999 12/31/2999J9999 00143968410 12/31/2999 12/31/2999J9999 00143977226 12/31/2999 5/13/2011J9999 00143978310 12/31/2999 12/31/2999J9999 00143978410 12/31/2999 12/31/2999J9999 00143978610 12/31/2999 12/31/2999J9999 00143978710 12/31/2999 12/31/2999J9999 00143987310 12/31/2999 12/31/2999J9999 00186015501 5/31/2013 7/13/2010

Page 203: *This document is a compilation of NDC:HCPCS combinations

J9999 00186024444 12/31/2999 2/1/2013J9999 00186103001 4/30/2013 8/4/2009J9999 00186103101 4/30/2013 11/5/2009J9999 00186103301 5/31/2013 9/16/2009J9999 00186103312 4/30/2013 1/4/2010J9999 00186103501 5/31/2013 9/1/2009J9999 00186103712 12/31/2999 8/4/2009J9999 00186602001 12/31/2999 12/31/2999J9999 00186604001 12/31/2999 12/31/2999J9999 00264553532 12/31/2999 12/31/2999J9999 00264762500 12/31/2999 12/31/2999J9999 00264780510 12/31/2999 12/31/2999J9999 00264780610 12/31/2999 12/31/2999J9999 00310030065 12/31/2999 3/17/2008J9999 00338005403 12/31/2999 12/31/2999J9999 00338005603 12/31/2999 12/31/2999J9999 00338101741 12/31/2999 12/31/2999J9999 00338101948 12/31/2999 12/31/2999J9999 00338104702 12/31/2999 12/31/2999J9999 00338104902 12/31/2999 12/31/2999J9999 00338105102 12/31/2999 12/31/2999J9999 00338105548 12/31/2999 12/31/2999J9999 00338519741 12/31/2999 12/31/2999J9999 00338519841 12/31/2999 10/18/2008J9999 00407408601 12/31/2999 12/31/2012J9999 00409114402 12/31/2999 12/31/2999J9999 00409115801 12/31/2999 12/31/2999J9999 00409115901 12/31/2999 12/31/2999J9999 00409115902 12/31/2999 12/31/2999J9999 00409116001 12/31/2999 12/31/2999J9999 00409116101 12/31/2999 12/31/2999J9999 00409116201 12/31/2999 12/31/2999J9999 00409116202 12/31/2999 12/31/2999J9999 00409116301 12/31/2999 12/31/2999J9999 00409116401 12/31/2999 12/31/2999J9999 00409116501 12/31/2999 12/31/2999J9999 00409116502 12/31/2999 12/31/2999J9999 00409117101 12/31/2999 12/31/2999J9999 00409117102 12/31/2999 12/31/2999J9999 00409132305 12/31/2999 12/31/2999J9999 00409141204 12/31/2999 12/31/2999J9999 00409141210 12/31/2999 12/31/2999J9999 00409141249 12/31/2999 12/31/2999J9999 00409141250 12/31/2999 12/31/2999J9999 00409148202 12/31/2999 12/31/2999J9999 00409148302 12/31/2999 12/31/2999J9999 00409148303 12/31/2999 12/31/2999

Page 204: *This document is a compilation of NDC:HCPCS combinations

J9999 00409148402 12/31/2999 12/31/2999J9999 00409148403 12/31/2999 12/31/2999J9999 00409155910 12/31/2999 12/31/2999J9999 00409155930 12/31/2999 12/31/2999J9999 00409156010 12/31/2999 12/31/2999J9999 00409156029 12/31/2999 12/31/2999J9999 00409158210 12/31/2999 12/31/2999J9999 00409158229 12/31/2999 12/31/2999J9999 00409158603 12/31/2999 12/31/2999J9999 00409158750 12/31/2999 12/31/2999J9999 00409161050 12/31/2999 12/31/2999J9999 00409163110 12/31/2999 12/31/2999J9999 00409163201 12/31/2999 12/31/2999J9999 00409163249 12/31/2999 12/31/2999J9999 00409163401 12/31/2999 12/31/2999J9999 00409177805 12/31/2999 12/31/2999J9999 00409177835 12/31/2999 12/31/2999J9999 00409205105 12/31/2999 12/31/2999J9999 00409205310 12/31/2999 12/31/2999J9999 00409206605 12/31/2999 12/31/2999J9999 00409212201 12/31/2999 12/31/2999J9999 00409212202 12/31/2999 12/31/2999J9999 00409212213 12/31/2999 12/31/2999J9999 00409212288 12/31/2999 12/31/2999J9999 00409226602 12/31/2999 12/31/2999J9999 00409226605 12/31/2999 12/31/2999J9999 00409226649 12/31/2999 12/31/2999J9999 00409226651 12/31/2999 12/31/2999J9999 00409226720 12/31/2999 12/31/2999J9999 00409226754 12/31/2999 12/31/2999J9999 00409228505 12/31/2999 12/31/2999J9999 00409233934 12/31/2999 12/31/2999J9999 00409329451 12/31/2999 12/31/2999J9999 00409329905 12/31/2999 12/31/2999J9999 00409329906 12/31/2999 12/31/2999J9999 00409401101 12/31/2999 12/31/2999J9999 00409405001 12/31/2999 12/31/2999J9999 00409405101 12/31/2999 12/31/2999J9999 00409405201 12/31/2999 12/31/2999J9999 00409405303 12/31/2999 12/31/2999J9999 00409405403 12/31/2999 12/31/2999J9999 00409405503 12/31/2999 12/31/2999J9999 00409405601 12/31/2999 12/31/2999J9999 00409419701 12/31/2999 12/31/2999J9999 00409427201 12/31/2999 12/31/2999J9999 00409427301 12/31/2999 12/31/2999J9999 00409427501 6/1/2013 6/1/2013

Page 205: *This document is a compilation of NDC:HCPCS combinations

J9999 00409427601 12/31/2999 12/31/2999J9999 00409427602 12/31/2999 12/31/2999J9999 00409427701 12/31/2999 12/31/2999J9999 00409427702 12/31/2999 12/31/2999J9999 00409427801 12/31/2999 12/31/2999J9999 00409428201 12/31/2999 12/31/2999J9999 00409428202 12/31/2999 12/31/2999J9999 00409428301 12/31/2999 12/31/2999J9999 00409434673 12/31/2999 12/31/2999J9999 00409435003 12/31/2999 12/31/2999J9999 00409469924 12/31/2999 12/31/2999J9999 00409469930 12/31/2999 12/31/2999J9999 00409469933 12/31/2999 12/31/2999J9999 00409469962 12/31/2999 12/31/2999J9999 00409477601 12/31/2999 12/31/2999J9999 00409490034 12/31/2999 12/31/2999J9999 00409490334 12/31/2999 12/31/2999J9999 00409491634 12/31/2999 12/31/2999J9999 00409492834 12/31/2999 12/31/2999J9999 00409553434 12/31/2999 12/31/2999J9999 00409562201 12/31/2999 12/31/2999J9999 00409575701 12/31/2999 12/31/2999J9999 00409660902 12/31/2999 12/31/2999J9999 00409662502 12/31/2999 12/31/2999J9999 00409663734 12/31/2999 12/31/2999J9999 00409669501 12/31/2999 12/31/2999J9999 00409669502 12/31/2999 12/31/2999J9999 00409711609 12/31/2999 12/31/2999J9999 00409729501 12/31/2999 5/1/2012J9999 00409729973 12/31/2999 12/31/2999J9999 00409744401 12/31/2999 12/31/2999J9999 00409744501 12/31/2999 12/31/2999J9999 00409781124 12/31/2999 12/31/2999J9999 00409781137 12/31/2999 12/31/2999J9999 00409790509 12/31/2999 12/31/2999J9999 00409806029 12/31/2999 12/31/2999J9999 00409806101 12/31/2999 12/31/2999J9999 00409806201 12/31/2999 12/31/2999J9999 00409818301 12/31/2999 12/31/2999J9999 00409963305 12/31/2999 12/31/2999J9999 00469352530 12/31/2999 12/31/2999J9999 00469357550 12/31/2999 12/31/2999J9999 00469650189 12/31/2999 12/31/2999J9999 00517041010 12/31/2999 12/31/2999J9999 00517051025 12/31/2999 12/31/2999J9999 00517078010 12/31/2999 12/31/2999J9999 00517078110 12/31/2999 12/31/2999

Page 206: *This document is a compilation of NDC:HCPCS combinations

J9999 00517101905 10/31/2012 12/31/2999J9999 00517102025 12/31/2999 12/31/2999J9999 00517135501 12/31/2999 12/31/2999J9999 00517135525 12/31/2999 12/31/2999J9999 00517205325 12/31/2999 12/31/2999J9999 00517209625 12/31/2999 12/31/2999J9999 00517230525 12/31/2999 12/31/2999J9999 00517231525 12/31/2999 12/31/2999J9999 00517235025 12/31/2999 12/31/2999J9999 00517271025 12/31/2999 12/31/2999J9999 00517306501 12/31/2999 12/31/2999J9999 00517460125 12/31/2999 12/31/2999J9999 00517460225 12/31/2999 12/31/2999J9999 00517460525 12/31/2999 12/31/2999J9999 00517462025 12/31/2999 12/31/2999J9999 00517481025 12/31/2999 12/31/2999J9999 00517501901 8/31/2013 12/31/2999J9999 00517502325 12/31/2999 12/31/2999J9999 00517502425 12/31/2999 12/31/2999J9999 00517505001 12/31/2999 12/31/2999J9999 00517621025 12/31/2999 12/31/2999J9999 00517912025 12/31/2999 12/31/2999J9999 00548330400 10/31/2014 1/25/2013J9999 00548335200 10/31/2014 11/28/2012J9999 00548339000 9/30/2014 11/20/2012J9999 00548824100 12/31/2999 4/1/2004J9999 00548824200 12/31/2999 4/1/2004J9999 00548824300 12/31/2999 4/1/2004J9999 00641276443 12/31/2999 4/4/2006J9999 00641276543 12/31/2999 4/4/2006J9999 00641276641 12/31/2999 4/4/2006J9999 00641296541 12/31/2013 12/31/2999J9999 00641296545 12/31/2013 12/31/2999J9999 00641600710 12/31/2999 12/31/2999J9999 00641600810 12/31/2999 12/31/2999J9999 00641601310 12/31/2999 12/31/2999J9999 00641601410 12/31/2999 12/31/2999J9999 00641601510 12/31/2999 12/31/2999J9999 00641601806 12/31/2999 12/31/2999J9999 00641602110 12/31/2999 12/31/2999J9999 00641602225 12/31/2999 12/31/2999J9999 00641602325 12/31/2999 12/31/2999J9999 00641603110 12/31/2999 12/31/2999J9999 00641603210 12/31/2999 12/31/2999J9999 00641603325 12/31/2999 12/31/2999J9999 00641603425 12/31/2999 12/31/2999J9999 00641603525 12/31/2999 12/31/2999

Page 207: *This document is a compilation of NDC:HCPCS combinations

J9999 00641603610 12/31/2999 12/31/2999J9999 00641610425 12/31/2999 12/31/2999J9999 00641610525 12/31/2999 12/31/2999J9999 00641610625 12/31/2999 12/31/2999J9999 00641610710 12/31/2999 12/31/2999J9999 00703291403 12/31/2999 12/31/2999J9999 00703292503 12/31/2999 12/31/2999J9999 00703410048 12/31/2999 12/31/2999J9999 00703410058 12/31/2999 12/31/2999J9999 00703410068 12/31/2999 12/31/2999J9999 00703840104 12/31/2999 12/31/2999J9999 00703841104 12/31/2999 12/31/2999J9999 00703950303 12/31/2999 12/31/2999J9999 00703951403 12/31/2999 12/31/2999J9999 00703952601 12/31/2999 12/31/2999J9999 00781300370 12/31/2999 12/31/2999J9999 00781300375 12/31/2999 12/31/2999J9999 00781300392 12/31/2999 12/31/2999J9999 00781300395 12/31/2999 12/31/2999J9999 00781305271 12/31/2999 12/31/2999J9999 00781305295 12/31/2999 12/31/2999J9999 00781307195 12/31/2999 12/31/2999J9999 00781312485 12/31/2999 12/31/2999J9999 00781312495 12/31/2999 12/31/2999J9999 00781312585 12/31/2999 12/31/2999J9999 00781312592 12/31/2999 12/31/2999J9999 00781312595 12/31/2999 12/31/2999J9999 00781312646 12/31/2999 12/31/2999J9999 00781312695 12/31/2999 12/31/2999J9999 00781312892 12/31/2999 12/31/2999J9999 00781312992 12/31/2999 12/31/2999J9999 00781315972 12/31/2999 12/31/2999J9999 00781328809 12/31/2999 12/31/2999J9999 00781328909 12/31/2999 12/31/2999J9999 00781329009 12/31/2999 12/31/2999J9999 00781912495 12/31/2999 12/31/2999J9999 00781912595 12/31/2999 12/31/2999J9999 00781912695 12/31/2999 12/31/2999J9999 00781922492 12/31/2999 12/31/2999J9999 00781922592 12/31/2999 12/31/2999J9999 10019001571 12/31/2999 4/16/2002J9999 10019001602 4/30/2014 10/10/2012J9999 10019001617 3/31/2014 10/10/2012J9999 10019001629 4/30/2014 10/10/2012J9999 10019001636 1/31/2014 7/25/2012J9999 10019001637 3/31/2014 10/10/2012J9999 10019001639 3/31/2014 9/7/2012

Page 208: *This document is a compilation of NDC:HCPCS combinations

J9999 10019001654 1/31/2014 7/25/2012J9999 10019001681 3/31/2014 9/7/2012J9999 10019004502 3/31/2014 5/4/2012J9999 10019004517 3/31/2014 5/4/2012J9999 10019004603 2/28/2014 11/13/2012J9999 10019004604 1/31/2014 11/13/2012J9999 10019004614 1/31/2014 5/31/2005J9999 10019004663 2/28/2014 11/13/2012J9999 10019005561 12/31/2999 12/31/2999J9999 10019006001 12/31/2999 4/5/2006J9999 10019006002 12/31/2999 4/5/2006J9999 10019007587 12/31/2999 12/31/2999J9999 10019009503 12/31/2999 2/28/2006J9999 10019009504 12/31/2999 3/10/2005J9999 10019011501 12/31/2999 12/31/2999J9999 10019011539 12/31/2999 12/31/2999J9999 10019012001 12/31/2999 12/31/2999J9999 10019021004 12/31/2999 9/30/2008J9999 10019032102 1/31/2013 9/7/2012J9999 10019032162 1/31/2013 9/7/2012J9999 10019048202 12/31/2999 3/4/2003J9999 10019050602 12/31/2999 12/31/2999J9999 10019050610 5/31/2013 4/3/2012J9999 10019050636 5/31/2013 4/3/2012J9999 10019050637 2/28/2013 4/3/2012J9999 10019050639 12/31/2999 12/31/2999J9999 10019050645 2/28/2013 4/3/2012J9999 10019051001 9/30/2013 1/6/2012J9999 10019051002 8/31/2013 1/6/2012J9999 10019051004 9/30/2013 1/6/2012J9999 10019051078 8/31/2013 1/6/2012J9999 10019051079 9/30/2013 1/6/2012J9999 11098006020 12/31/2999 4/26/2005J9999 15054006001 12/31/2999 12/31/2999J9999 15054009001 12/31/2999 12/31/2999J9999 15054050001 12/31/2999 12/31/2999J9999 17478006702 12/31/2999 12/31/2999J9999 17478006705 12/31/2999 12/31/2999J9999 17478012050 12/31/2999 12/31/2999J9999 17478012150 12/31/2999 12/31/2999J9999 17478012250 12/31/2999 12/31/2999J9999 17478015142 12/31/2999 12/31/2999J9999 17478042020 12/31/2999 12/31/2999J9999 17478042040 12/31/2999 12/31/2999J9999 17478093705 12/31/2999 12/31/2999J9999 17478093710 12/31/2999 12/31/2999J9999 17478093725 12/31/2999 12/31/2999

Page 209: *This document is a compilation of NDC:HCPCS combinations

J9999 23360003105 12/31/2999 5/1/2011J9999 23360003110 12/31/2999 5/1/2011J9999 25021011502 12/31/2999 12/31/2999J9999 25021011504 12/31/2999 12/31/2999J9999 25021011506 12/31/2999 12/31/2999J9999 25021011551 12/31/2999 12/31/2999J9999 25021013182 12/31/2999 5/31/2010J9999 25021030020 12/31/2999 12/31/2999J9999 25021030040 12/31/2999 12/31/2999J9999 25021030305 12/31/2999 12/31/2999J9999 25021060005 12/31/2999 12/31/2999J9999 25021060010 12/31/2999 12/31/2999J9999 25021065710 12/31/2999 6/13/2013J9999 25021065820 12/31/2999 12/31/2999J9999 25021067410 12/31/2999 12/31/2999J9999 25021067420 12/31/2999 12/31/2999J9999 36000002612 12/31/2999 12/31/2999J9999 36000002712 12/31/2999 12/31/2999J9999 36000003310 12/31/2999 12/31/2999J9999 39822027702 12/31/2999 12/31/2999J9999 39822027705 12/31/2999 3/31/2012J9999 39822027707 12/31/2999 3/31/2012J9999 41616093140 12/31/2999 12/31/2999J9999 41616093144 12/31/2999 12/31/2999J9999 41616093244 12/31/2999 12/31/2999J9999 42023011310 12/31/2999 12/31/2999J9999 42023011410 12/31/2999 12/31/2999J9999 42023011510 12/31/2999 12/31/2999J9999 42023011725 12/31/2999 12/31/2999J9999 47335008250 12/31/2999 12/31/2999J9999 47783010101 12/31/2999 12/31/2999J9999 48818000101 12/31/2999 12/31/2999J9999 48818000102 12/31/2999 12/31/2999J9999 50242013501 12/31/2999 12/31/2999J9999 50242013601 12/31/2999 12/31/2999J9999 50242013701 12/31/2999 12/31/2999J9999 50242014501 12/31/2999 12/31/2999J9999 50458040101 12/31/2999 12/31/2999J9999 50458040102 12/31/2999 12/31/2999J9999 50458056001 12/31/2999 12/31/2999J9999 50458056101 12/31/2999 12/31/2999J9999 50458056201 12/31/2999 12/31/2999J9999 50458056301 12/31/2999 12/31/2999J9999 50458056401 12/31/2999 12/31/2999J9999 50474000263 12/31/2999 12/31/2999J9999 50474070062 12/31/2999 12/31/2999J9999 50633021011 12/31/2999 12/31/2999

Page 210: *This document is a compilation of NDC:HCPCS combinations

J9999 51144005001 12/31/2999 12/31/2999J9999 54569166000 12/31/2999 1/31/2003J9999 54569326000 12/31/2999 5/5/2011J9999 54569391600 12/31/2999 1/31/2003J9999 54569482100 12/31/2999 1/31/2003J9999 54569532200 12/31/2999 6/1/2003J9999 54868074100 12/31/2999 6/30/2011J9999 54868076500 12/31/2999 9/7/2012J9999 54868173800 12/31/2999 9/30/2011J9999 54868179500 12/31/2999 6/30/2012J9999 54868179801 12/31/2999 6/30/2012J9999 54868206400 12/31/2999 6/30/2012J9999 54868206401 12/31/2999 6/30/2012J9999 54868313400 12/31/2999 7/31/2011J9999 54868313401 12/31/2999 12/31/2999J9999 54868323101 12/31/2999 6/30/2001J9999 54868339200 12/31/2999 6/30/2011J9999 54868343700 12/31/2999 6/30/2012J9999 54868369500 12/31/2999 6/30/2011J9999 54868380900 12/31/2999 6/30/2011J9999 54868380901 12/31/2999 6/30/2011J9999 54868392000 12/31/2999 2/10/2009J9999 54868415400 12/31/2999 6/30/2011J9999 54868416900 12/31/2999 6/30/2010J9999 54868439900 12/31/2999 6/30/2012J9999 54868448600 12/31/2999 6/30/2011J9999 54868459600 12/31/2999 6/30/2011J9999 54868462900 12/31/2999 6/30/2011J9999 54868488700 12/31/2999 6/30/2011J9999 54868509300 12/31/2999 6/30/2011J9999 54868571500 12/31/2999 12/31/2999J9999 54868571800 12/31/2999 6/30/2011J9999 54868572300 12/31/2999 6/30/2012J9999 54868572600 12/31/2999 6/30/2012J9999 54868574000 12/31/2999 12/31/2999J9999 54868574001 12/31/2999 12/31/2999J9999 54868626700 12/31/2999 12/31/2999J9999 55150016710 12/31/2999 12/31/2999J9999 55150016830 12/31/2999 12/31/2999J9999 55150016910 12/31/2999 12/31/2999J9999 55150017030 12/31/2999 12/31/2999J9999 55150017110 12/31/2999 12/31/2999J9999 55150017230 12/31/2999 12/31/2999J9999 55390001010 12/31/2999 12/31/2999J9999 55390001110 12/31/2999 12/31/2999J9999 55390002601 12/31/2999 12/31/2999J9999 55390002701 12/31/2999 12/31/2999

Page 211: *This document is a compilation of NDC:HCPCS combinations

J9999 55390002810 12/31/2999 12/31/2999J9999 55390002910 12/31/2999 12/31/2999J9999 55390003501 12/31/2999 12/31/2999J9999 55390003710 12/31/2999 12/31/2999J9999 55390003910 12/31/2999 12/31/2999J9999 55390006210 12/31/2999 12/31/2999J9999 55390007310 12/31/2999 12/31/2999J9999 55390009210 12/31/2999 12/31/2999J9999 55390009310 12/31/2999 12/31/2999J9999 55390010601 12/31/2999 12/31/2999J9999 55390012301 12/31/2999 12/31/2999J9999 55390013020 12/31/2999 12/31/2999J9999 55390013040 12/31/2999 12/31/2999J9999 55390034010 12/31/2999 4/18/2013J9999 55390034810 12/31/2999 4/18/2013J9999 55390047510 12/31/2999 12/31/2999J9999 55390050002 12/31/2999 12/31/2999J9999 55390050005 12/31/2999 12/31/2999J9999 55390050010 12/31/2999 12/31/2999J9999 55390056505 12/31/2999 12/31/2999J9999 55390056510 12/31/2999 12/31/2999J9999 55390056530 12/31/2999 12/31/2999J9999 55390056605 12/31/2999 4/18/2013J9999 55390056610 12/31/2999 4/18/2013J9999 55390056630 12/31/2999 4/18/2013J9999 55390076210 12/31/2999 12/31/2999J9999 55390076320 12/31/2999 12/31/2999J9999 55513071001 12/31/2999 12/31/2999J9999 55513073001 12/31/2999 12/31/2999J9999 57894006003 12/31/2999 12/31/2999J9999 58016499601 12/31/2999 11/29/2012J9999 58016933101 12/31/2999 11/29/2012J9999 58016934301 12/31/2999 10/17/2012J9999 58394001201 12/31/2999 12/31/2999J9999 58394001301 12/31/2999 12/31/2999J9999 58394001401 12/31/2999 12/31/2999J9999 58394001501 12/31/2999 12/31/2999J9999 58468015001 12/31/2999 12/31/2999J9999 58468016001 12/31/2999 12/31/2999J9999 59338077501 12/31/2999 12/31/2999J9999 59338077510 12/31/2999 12/31/2999J9999 59730560101 12/31/2999 1/9/2009J9999 60505070401 12/31/2999 2/3/2006J9999 60505070402 12/31/2999 2/3/2006J9999 60505071700 12/31/2999 10/1/2011J9999 60505071701 12/31/2999 7/3/2006J9999 60505071702 12/31/2999 8/1/2008

Page 212: *This document is a compilation of NDC:HCPCS combinations

J9999 60505071703 12/31/2999 8/1/2008J9999 60977014402 6/30/2013 5/4/2012J9999 60977014463 6/30/2013 5/4/2012J9999 60977015501 3/31/2014 10/19/2012J9999 60977015502 3/31/2014 10/19/2012J9999 60977015503 1/31/2014 7/25/2012J9999 60977015504 12/31/2999 2/22/2006J9999 60977015506 10/31/2013 7/25/2012J9999 60977015554 1/31/2014 7/25/2012J9999 61553019341 12/31/2999 12/31/2999J9999 61553024337 12/31/2999 12/31/2999J9999 61553024802 12/31/2999 12/31/2999J9999 61703021309 12/31/2999 5/24/2002J9999 61703021311 12/31/2999 5/24/2002J9999 61703021321 12/31/2999 5/24/2002J9999 61703023322 12/31/2999 8/1/2006J9999 61703023341 12/31/2999 8/1/2006J9999 61958090101 12/31/2999 12/31/2999J9999 62856038901 12/31/2999 12/31/2999J9999 63323002605 12/31/2999 12/31/2999J9999 63323003250 12/31/2999 12/31/2007J9999 63323003261 12/31/2999 12/31/2999J9999 63323006620 12/31/2999 12/31/2007J9999 63323006650 12/31/2999 12/31/2007J9999 63323006661 12/31/2999 12/31/2007J9999 63323011410 12/31/2999 12/31/2007J9999 63323013011 12/31/2999 12/31/2999J9999 63323013013 12/31/2999 12/31/2999J9999 63323018410 12/31/2999 12/31/2999J9999 63323018411 12/31/2999 12/31/2999J9999 63323020102 12/31/2999 12/31/2999J9999 63323020110 12/31/2999 12/31/2999J9999 63323020202 12/31/2999 12/31/2999J9999 63323020805 12/31/2999 12/31/2999J9999 63323026920 12/31/2999 3/7/2013J9999 63323026927 12/31/2999 12/31/2999J9999 63323026929 12/31/2999 12/31/2999J9999 63323026937 12/31/2999 12/31/2999J9999 63323026950 12/31/2999 12/31/2999J9999 63323026957 12/31/2999 12/31/2999J9999 63323026959 12/31/2999 12/31/2999J9999 63323026965 12/31/2999 12/31/2999J9999 63323026967 12/31/2999 12/31/2999J9999 63323026969 12/31/2999 12/31/2999J9999 63323026994 12/31/2999 12/31/2999J9999 63323027025 12/31/2999 12/31/2999J9999 63323027026 12/31/2999 12/31/2999

Page 213: *This document is a compilation of NDC:HCPCS combinations

J9999 63323027027 1/30/2013 6/8/2011J9999 63323027050 12/31/2999 12/31/2999J9999 63323027057 12/31/2999 12/31/2999J9999 63323027065 12/31/2999 12/31/2999J9999 63323027067 12/31/2999 12/31/2999J9999 63323028202 12/31/2999 12/31/2999J9999 63323028204 12/31/2999 12/31/2999J9999 63323028206 12/31/2999 12/31/2999J9999 63323028260 12/31/2999 12/31/2999J9999 63323029730 12/31/2999 12/31/2999J9999 63323029731 12/31/2999 2/1/2013J9999 63323029750 12/31/2999 12/31/2999J9999 63323029751 12/31/2999 2/1/2013J9999 63323029753 12/31/2999 2/1/2013J9999 63323029766 12/31/2999 12/31/2999J9999 63323030201 12/31/2999 12/31/2999J9999 63323032930 12/31/2999 12/31/2999J9999 63323040120 12/31/2999 12/31/2999J9999 63323040220 12/31/2999 12/31/2999J9999 63323042405 12/31/2999 12/31/2999J9999 63323042410 12/31/2999 12/31/2999J9999 63323046410 4/30/2015 11/8/2011J9999 63323046417 12/31/2999 12/31/2999J9999 63323046430 9/30/2014 1/21/2011J9999 63323046431 12/31/2999 12/31/2999J9999 63323046433 12/31/2999 12/31/2999J9999 63323046437 12/31/2999 12/31/2999J9999 63323046550 3/30/2015 9/8/2011J9999 63323046557 12/31/2999 12/31/2999J9999 63323046610 5/30/2014 5/18/2011J9999 63323046617 12/31/2999 12/31/2999J9999 63323046630 12/30/2013 2/4/2011J9999 63323046631 12/31/2999 12/31/2999J9999 63323046633 12/31/2999 12/31/2999J9999 63323046637 12/31/2999 12/31/2999J9999 63323046750 3/30/2015 6/24/2011J9999 63323046757 12/31/2999 12/31/2999J9999 63323047210 12/31/2999 2/13/2012J9999 63323047217 12/31/2999 12/31/2999J9999 63323047230 6/30/2013 3/2/2011J9999 63323047233 12/31/2999 12/31/2999J9999 63323047237 12/31/2999 12/31/2999J9999 63323048520 10/30/2014 4/26/2011J9999 63323048550 3/30/2015 9/27/2011J9999 63323048610 5/30/2014 9/21/2011J9999 63323048620 12/30/2014 9/8/2011J9999 63323049089 12/31/2999 12/31/2999

Page 214: *This document is a compilation of NDC:HCPCS combinations

J9999 63323049150 11/30/2013 1/6/2011J9999 63323049202 4/30/2015 8/2/2011J9999 63323049205 3/30/2014 1/20/2011J9999 63323049230 6/30/2014 1/21/2011J9999 63323049231 12/31/2999 12/31/2999J9999 63323049280 12/31/2999 12/31/2999J9999 63323049289 12/31/2999 12/31/2999J9999 63323049297 12/31/2999 12/31/2999J9999 63323049391 12/31/2999 12/31/2999J9999 63323049397 12/31/2999 12/31/2999J9999 63323049405 12/31/2999 12/31/2999J9999 63323049502 12/30/2014 11/30/2010J9999 63323049505 1/30/2015 4/1/2011J9999 63323049680 12/31/2999 12/31/2999J9999 63323049697 12/31/2999 12/31/2999J9999 63323049889 12/31/2999 12/31/2999J9999 63323065210 12/31/2999 12/31/2999J9999 63323066005 12/31/2999 12/31/2999J9999 63323073804 12/31/2999 11/13/2012J9999 63323073809 12/31/2999 12/31/2999J9999 63323073820 12/31/2999 12/31/2999J9999 63323073912 12/31/2999 12/31/2999J9999 63459039120 12/31/2999 12/31/2999J9999 63833082502 12/31/2999 12/31/2999J9999 64208823401 12/31/2999 12/31/2999J9999 64208823402 12/31/2999 12/31/2999J9999 64208823403 12/31/2999 12/31/2999J9999 65293000200 12/31/2999 10/3/2011J9999 65293000211 5/31/2012 10/3/2011J9999 65293000250 12/31/2999 10/3/2011J9999 65293000255 5/31/2012 10/3/2011J9999 65293000500 12/31/2999 12/31/2999J9999 65293000511 12/31/2999 12/31/2999J9999 65293000550 12/31/2999 12/31/2999J9999 65293000555 12/31/2999 12/31/2999J9999 65483035502 12/31/2999 2/10/2009J9999 65483035504 12/31/2999 2/10/2009J9999 66302020601 12/31/2999 12/31/2999J9999 66302020602 12/31/2999 12/31/2999J9999 66302020603 12/31/2999 12/31/2999J9999 66479002539 12/31/2999 5/13/2005J9999 66658023407 12/31/2999 12/31/2999J9999 66658023428 12/31/2999 12/31/2999J9999 66860012002 12/31/2999 12/31/2999J9999 66887000301 12/31/2999 12/31/2999J9999 67457000110 12/31/2999 12/31/2999J9999 67457010810 12/31/2999 12/31/2999

Page 215: *This document is a compilation of NDC:HCPCS combinations

J9999 67457011850 12/31/2999 12/31/2999J9999 67457018120 12/31/2999 12/31/2999J9999 67457018210 12/31/2999 12/31/2999J9999 67457018320 12/31/2999 12/31/2999J9999 67457018750 12/31/2999 12/31/2999J9999 67457019015 12/31/2999 12/31/2999J9999 67457019115 12/31/2999 9/1/2011J9999 67457019205 12/31/2999 12/31/2999J9999 67467018101 2/12/2013 12/31/2999J9999 67467018102 9/15/2013 12/31/2999J9999 76075010101 12/31/2999 12/31/2999J9999 76125090001 12/31/2999 12/31/2999J9999 76125090010 12/31/2999 12/31/2999J9999 76125090020 12/31/2999 12/31/2999J9999 76125090025 12/31/2999 12/31/2999J9999 76125090050 12/31/2999 12/31/2999P9041 00053767031 12/31/2999 12/31/2999P9041 00053767032 12/31/2999 12/31/2999P9041 00944049101 12/31/2999 12/31/2999P9041 00944049102 12/31/2999 12/31/2999P9041 13533068520 12/31/2999 12/31/2999P9041 13533068525 12/31/2999 12/31/2999P9041 13533069020 12/31/2999 12/31/2999P9041 13533069025 12/31/2999 12/31/2999P9041 44206031025 12/31/2999 12/31/2999P9041 44206031050 12/31/2999 12/31/2999P9041 63546031025 12/31/2999 6/27/2007P9041 63546031050 12/31/2999 6/27/2007P9041 67467062301 12/31/2999 12/31/2999P9041 67467062302 12/31/2999 12/31/2999P9041 67467062303 12/31/2999 12/31/2999P9041 68209062301 12/31/2999 12/31/2999P9041 68209062302 12/31/2999 12/31/2999P9041 68209062303 12/31/2999 12/31/2999P9041 68516521101 1/17/2012 4/1/2009P9041 68516521102 2/13/2012 4/1/2009P9041 68516521401 12/31/2999 12/31/2999P9041 68516521402 12/31/2999 12/31/2999P9041 76125078505 12/31/2999 1/1/2012P9041 76125078525 12/31/2999 12/31/2999P9043 13533061320 12/31/2999 12/31/2999P9043 13533061325 12/31/2999 12/31/2999P9045 00053767003 12/31/2999 11/17/2006P9045 00053767031 12/31/2999 12/31/2999P9045 00053767032 12/31/2999 12/31/2999P9045 00944049101 12/31/2999 12/31/2999P9045 00944049102 12/31/2999 12/31/2999

Page 216: *This document is a compilation of NDC:HCPCS combinations

P9045 13533068520 12/31/2999 12/31/2999P9045 13533068525 12/31/2999 12/31/2999P9045 13533069020 12/31/2999 12/31/2999P9045 13533069025 12/31/2999 12/31/2999P9045 44206031025 12/31/2999 12/31/2999P9045 44206031050 12/31/2999 12/31/2999P9045 63546031025 12/31/2999 6/27/2007P9045 63546031050 12/31/2999 6/27/2007P9045 67467062301 12/31/2999 12/31/2999P9045 67467062302 12/31/2999 12/31/2999P9045 67467062303 12/31/2999 12/31/2999P9045 68209062301 12/31/2999 12/31/2999P9045 68209062302 12/31/2999 12/31/2999P9045 68209062303 12/31/2999 12/31/2999P9045 68516521101 1/17/2012 4/1/2009P9045 68516521102 2/13/2012 4/1/2009P9045 68516521401 12/31/2999 12/31/2999P9045 68516521402 12/31/2999 12/31/2999P9045 76125078525 12/31/2999 12/31/2999P9046 00053768001 12/31/2999 11/17/2006P9046 00053768032 12/31/2999 12/31/2999P9046 00053768033 12/31/2999 12/31/2999P9046 00944049001 12/31/2999 12/31/2999P9046 00944049002 12/31/2999 12/31/2999P9046 00944049003 12/31/2999 12/31/2999P9046 00944049301 12/31/2999 12/31/2999P9046 00944049302 12/31/2999 12/31/2999P9046 13533068416 12/31/2999 12/31/2999P9046 13533068420 12/31/2999 12/31/2999P9046 13533068471 12/31/2999 12/31/2999P9046 13533069216 12/31/2999 12/31/2999P9046 13533069220 12/31/2999 12/31/2999P9046 13533069271 12/31/2999 12/31/2999P9046 44206025105 12/31/2999 12/31/2999P9046 44206025110 12/31/2999 12/31/2999P9046 61953000201 12/31/2999 12/31/2999P9046 61953000202 12/31/2999 12/31/2999P9046 63546025105 12/31/2999 6/27/2007P9046 63546025110 12/31/2999 6/27/2007P9046 67467064301 12/31/2999 12/31/2999P9046 67467064302 12/31/2999 12/31/2999P9046 68209064301 12/31/2999 12/31/2999P9046 68209064302 12/31/2999 12/31/2999P9046 68516521602 12/31/2999 12/31/2999P9046 76125078410 12/31/2999 12/31/2999P9046 76125078425 12/31/2999 12/31/2999P9046 76179002501 12/31/2999 12/31/2999

Page 217: *This document is a compilation of NDC:HCPCS combinations

P9046 76179002502 12/31/2999 12/31/2999P9047 00053768032 12/31/2999 12/31/2999P9047 00053768033 12/31/2999 12/31/2999P9047 00944049001 12/31/2999 12/31/2999P9047 00944049002 12/31/2999 12/31/2999P9047 00944049003 12/31/2999 12/31/2999P9047 00944049301 12/31/2999 12/31/2999P9047 00944049302 12/31/2999 12/31/2999P9047 13533068416 12/31/2999 12/31/2999P9047 13533068420 12/31/2999 12/31/2999P9047 13533068471 12/31/2999 12/31/2999P9047 13533069216 12/31/2999 12/31/2999P9047 13533069220 12/31/2999 12/31/2999P9047 13533069271 12/31/2999 12/31/2999P9047 44206025105 12/31/2999 12/31/2999P9047 44206025110 12/31/2999 12/31/2999P9047 61953000201 12/31/2999 12/31/2999P9047 61953000202 12/31/2999 12/31/2999P9047 63546025105 12/31/2999 6/27/2007P9047 63546025110 12/31/2999 6/27/2007P9047 67467064301 12/31/2999 12/31/2999P9047 67467064302 12/31/2999 12/31/2999P9047 68209064301 12/31/2999 12/31/2999P9047 68209064302 12/31/2999 12/31/2999P9047 68516521601 12/31/2999 12/31/2999P9047 68516521602 12/31/2999 12/31/2999P9047 76125078410 12/31/2999 12/31/2999P9047 76125078425 12/31/2999 12/31/2999P9047 76179002501 12/31/2999 12/31/2999P9047 76179002502 12/31/2999 12/31/2999P9048 13533061320 12/31/2999 12/31/2999P9048 13533061325 12/31/2999 12/31/2999Q0138 59338077501 12/31/2999 12/31/2999Q0138 59338077510 12/31/2999 12/31/2999Q0139 59338077501 12/31/2999 12/31/2999Q0139 59338077510 12/31/2999 12/31/2999Q0144 00069305107 12/31/2999 12/31/2999Q0144 00069305175 12/31/2999 12/31/2999Q0144 00069306030 12/31/2999 12/31/2999Q0144 00069306075 12/31/2999 12/31/2999Q0144 00069306086 12/31/2999 12/31/2999Q0144 00069307030 12/31/2999 12/31/2999Q0144 00069307075 12/31/2999 12/31/2999Q0144 00069307086 12/31/2999 12/31/2999Q0144 00069308030 12/31/2999 12/31/2999Q0144 00069311019 12/31/2999 12/31/2999Q0144 00069312019 12/31/2999 12/31/2999

Page 218: *This document is a compilation of NDC:HCPCS combinations

Q0144 00069313019 12/31/2999 12/31/2999Q0144 00069314019 12/31/2999 12/31/2999Q0144 00069417034 12/31/2999 12/31/2999Q0144 00093714609 12/31/2999 12/31/2999Q0144 00093714618 12/31/2999 12/31/2999Q0144 00093714656 12/31/2999 12/31/2999Q0144 00093714756 12/31/2999 12/31/2999Q0144 00093714823 12/31/2999 12/31/2999Q0144 00093714923 12/31/2999 12/31/2999Q0144 00093714931 12/31/2999 12/31/2999Q0144 00093714994 12/31/2999 12/31/2999Q0144 00093716933 12/31/2999 12/31/2999Q0144 00093716956 12/31/2999 12/31/2999Q0144 00093716990 12/31/2999 12/31/2999Q0144 00185720370 12/31/2999 12/31/2999Q0144 00185720670 12/31/2999 12/31/2999Q0144 00185720969 12/31/2999 12/31/2999Q0144 00185721268 12/31/2999 12/31/2999Q0144 00781149631 12/31/2999 12/31/2999Q0144 00781149668 12/31/2999 12/31/2999Q0144 00781149669 12/31/2999 12/31/2999Q0144 00781149731 12/31/2999 12/31/2999Q0144 00781194131 12/31/2999 12/31/2999Q0144 00781194133 12/31/2999 12/31/2999Q0144 00904601004 12/31/2999 12/31/2999Q0144 16590024806 12/31/2999 12/31/2999Q0144 21695001206 12/31/2999 12/31/2999Q0144 21695001303 12/31/2999 12/31/2999Q0144 21695044460 12/31/2999 12/31/2999Q0144 21695054815 12/31/2999 12/31/2999Q0144 21695054915 12/31/2999 12/31/2999Q0144 21695054930 12/31/2999 12/31/2999Q0144 23490690401 12/31/2999 12/31/2999Q0144 23490690500 12/31/2999 12/31/2999Q0144 23490690501 12/31/2999 12/31/2999Q0144 23490690502 12/31/2999 12/31/2999Q0144 23490775801 12/31/2999 12/31/2999Q0144 23490776001 12/31/2999 12/31/2999Q0144 23490776002 12/31/2999 12/31/2999Q0144 33358004006 12/31/2999 12/31/2999Q0144 33358004110 12/31/2999 12/31/2999Q0144 33358036701 12/31/2999 12/31/2999Q0144 33358036703 12/31/2999 12/31/2999Q0144 33358036804 12/31/2999 12/31/2999Q0144 33358036830 12/31/2999 12/31/2999Q0144 33358036850 12/31/2999 12/31/2999Q0144 35356001703 12/31/2999 12/31/2999

Page 219: *This document is a compilation of NDC:HCPCS combinations

Q0144 35356004415 12/31/2999 12/31/2999Q0144 35356012815 12/31/2999 12/31/2999Q0144 35356019915 12/31/2999 12/31/2999Q0144 35356048701 12/31/2999 12/31/2999Q0144 43063009002 12/31/2999 12/31/2999Q0144 49999009604 12/31/2999 12/31/2999Q0144 49999009606 12/31/2999 12/31/2999Q0144 49999026015 12/31/2999 12/31/2999Q0144 49999058215 12/31/2999 12/31/2999Q0144 49999078606 12/31/2999 12/31/2999Q0144 50111078766 12/31/2999 12/31/2999Q0144 50111078852 12/31/2999 12/31/2999Q0144 52959031315 12/31/2999 12/31/2999Q0144 52959065703 12/31/2999 12/31/2999Q0144 52959065706 12/31/2999 12/31/2999Q0144 52959083806 12/31/2999 12/31/2999Q0144 52959093230 12/31/2999 12/31/2999Q0144 54569423000 12/31/2999 2/1/2009Q0144 54569423100 12/31/2999 5/20/2011Q0144 54569423200 12/31/2999 12/31/2999Q0144 54569449700 12/31/2999 12/31/2999Q0144 54569452200 12/31/2999 12/31/2999Q0144 54569452201 12/31/2999 8/1/2012Q0144 54569452202 12/31/2999 12/31/2999Q0144 54569456700 12/31/2999 12/31/2999Q0144 54569544800 12/31/2999 12/31/2999Q0144 54569575400 12/31/2999 12/31/2999Q0144 54569575500 12/31/2999 12/31/2999Q0144 54569575600 12/31/2999 12/31/2999Q0144 54569580400 12/31/2999 12/31/2999Q0144 54569580600 12/31/2999 12/31/2999Q0144 54569580700 12/31/2999 12/31/2999Q0144 54569580800 12/31/2999 12/31/2999Q0144 54569580900 12/31/2999 12/31/2999Q0144 54569581000 12/31/2999 12/31/2999Q0144 54868324400 12/31/2999 6/30/2012Q0144 54868364800 12/31/2999 12/31/2999Q0144 54868407600 12/31/2999 6/30/2012Q0144 54868407800 12/31/2999 6/30/2012Q0144 54868407801 12/31/2999 6/30/2012Q0144 54868407802 12/31/2999 6/30/2012Q0144 54868418300 12/31/2999 6/30/2010Q0144 54868464400 12/31/2999 6/30/2012Q0144 54868464401 12/31/2999 6/30/2012Q0144 54868464402 12/31/2999 6/30/2012Q0144 54868540400 12/31/2999 6/30/2010Q0144 54868547100 12/31/2999 12/31/2999

Page 220: *This document is a compilation of NDC:HCPCS combinations

Q0144 54868547800 12/31/2999 12/31/2999Q0144 54868547801 12/31/2999 12/31/2999Q0144 54868547802 12/31/2999 12/31/2999Q0144 54868548700 12/31/2999 12/31/2999Q0144 54868548701 12/31/2999 6/30/2012Q0144 54868564700 12/31/2999 12/31/2999Q0144 54868564800 12/31/2999 12/31/2999Q0144 54868564801 12/31/2999 12/31/2999Q0144 54868564802 12/31/2999 12/31/2999Q0144 54868593800 12/31/2999 12/31/2999Q0144 55289027402 12/31/2999 12/31/2999Q0144 55289027403 12/31/2999 12/31/2999Q0144 55289031004 12/31/2999 12/31/2999Q0144 55289031006 12/31/2999 12/31/2999Q0144 55289031014 12/31/2999 12/31/2999Q0144 55289096404 12/31/2999 12/31/2999Q0144 55289096414 12/31/2999 12/31/2999Q0144 58016008600 12/31/2999 11/29/2012Q0144 58016008630 12/31/2999 11/29/2012Q0144 58016008660 12/31/2999 11/29/2012Q0144 58016008690 12/31/2999 11/29/2012Q0144 58016039100 12/31/2999 11/29/2012Q0144 58016039101 12/31/2999 11/29/2012Q0144 58016039106 12/31/2999 11/29/2012Q0144 58016039110 12/31/2999 11/29/2012Q0144 58016039115 12/31/2999 11/29/2012Q0144 58016039118 12/31/2999 11/29/2012Q0144 58016039120 12/31/2999 11/29/2012Q0144 58016039128 12/31/2999 11/29/2012Q0144 58016039130 12/31/2999 11/29/2012Q0144 58016039160 12/31/2999 11/29/2012Q0144 58016039190 12/31/2999 11/29/2012Q0144 58016481401 12/31/2999 11/29/2012Q0144 58864065504 12/31/2999 12/31/2999Q0144 58864065506 12/31/2999 12/31/2999Q0144 58864065514 12/31/2999 12/31/2999Q0144 58864079106 12/31/2999 5/1/2011Q0144 59762305101 12/31/2999 12/31/2999Q0144 59762305102 12/31/2999 12/31/2999Q0144 59762306001 12/31/2999 12/31/2999Q0144 59762306002 12/31/2999 12/31/2999Q0144 59762306003 12/31/2999 12/31/2999Q0144 59762307001 12/31/2999 12/31/2999Q0144 59762307002 12/31/2999 12/31/2999Q0144 59762308001 12/31/2999 12/31/2999Q0144 59762311001 12/31/2999 12/31/2999Q0144 59762312001 12/31/2999 12/31/2999

Page 221: *This document is a compilation of NDC:HCPCS combinations

Q0144 59762313001 12/31/2999 12/31/2999Q0144 59762314001 12/31/2999 12/31/2999Q0144 64679096101 12/31/2999 12/31/2999Q0144 64679096104 12/31/2999 12/31/2999Q0144 64679096105 12/31/2999 12/31/2999Q0144 64679096201 12/31/2999 12/31/2999Q0144 64679096401 12/31/2999 12/31/2999Q0144 64679096403 12/31/2999 12/31/2999Q0144 64679096405 12/31/2999 12/31/2999Q0144 66267092806 12/31/2999 12/31/2999Q0144 68084027801 12/31/2999 12/31/2999Q0144 68084027811 12/31/2999 12/31/2999Q0144 68084027911 12/31/2999 12/31/2999Q0144 68084027921 12/31/2999 12/31/2999Q0144 68387056506 12/31/2999 12/31/2999Q0162 00093023333 1/31/2014 2/1/2013Q0162 00093023356 12/31/2999 12/31/2999Q0162 00093023393 8/31/2013 11/20/2012Q0162 00093723633 1/31/2014 2/1/2013Q0162 00093723656 12/31/2999 12/31/2999Q0162 00093723693 1/31/2014 11/20/2012Q0162 00093730165 1/31/2013 6/17/2011Q0162 00143242230 12/31/2999 4/10/2012Q0162 00143242330 12/31/2999 4/10/2012Q0162 00173044600 12/31/2999 12/31/2999Q0162 00173044602 11/30/2013 8/29/2011Q0162 00173044700 12/31/2999 12/31/2999Q0162 00173044702 7/31/2013 12/31/2999Q0162 00173044704 12/31/2999 12/31/2999Q0162 00173048900 12/31/2999 12/31/2999Q0162 00173056900 12/31/2999 12/31/2999Q0162 00173057000 12/31/2999 12/31/2999Q0162 00378031593 12/31/2999 12/31/2999Q0162 00378034493 12/31/2999 12/31/2999Q0162 00378773293 12/31/2999 12/31/2999Q0162 00378773493 12/31/2999 12/31/2999Q0162 00378773497 12/31/2999 12/31/2999Q0162 00781167931 12/31/2999 12/31/2999Q0162 00781167933 12/31/2999 12/31/2999Q0162 00781168131 12/31/2999 12/31/2999Q0162 00781168133 12/31/2999 12/31/2999Q0162 00781523864 12/31/2999 12/31/2999Q0162 00781523964 12/31/2999 12/31/2999Q0162 00781523980 12/31/2999 12/31/2999Q0162 00781525731 1/31/2013 12/1/2010Q0162 00781525831 2/28/2013 12/1/2010Q0162 51672409103 12/31/2999 12/31/2999

Page 222: *This document is a compilation of NDC:HCPCS combinations

Q0162 54569587300 12/31/2999 12/31/2999Q0162 55111015313 8/31/2013 12/31/2999Q0162 55111015330 12/31/2999 12/31/2999Q0162 55111015413 8/31/2013 12/31/2999Q0162 55111015430 12/31/2999 12/31/2999Q0162 59762299001 12/31/2999 12/31/2999Q0162 59762299002 12/31/2999 12/31/2999Q0162 59762299301 12/31/2999 12/31/2999Q0162 59762299302 12/31/2999 12/31/2999Q0162 68084022001 12/31/2999 12/31/2999Q0162 68084022101 12/31/2999 12/31/2999Q0163 00113037926 12/31/2999 12/31/2999Q0163 00113043162 12/31/2999 12/31/2999Q0163 00113046262 12/31/2999 12/31/2999Q0163 00113047962 12/31/2999 12/31/2999Q0163 00113047978 12/31/2999 12/31/2999Q0163 00121048905 12/31/2999 12/31/2999Q0163 00121048910 12/31/2999 12/31/2999Q0163 00121048920 12/31/2999 6/10/2011Q0163 00135005707 11/30/2016 12/31/2999Q0163 00135005807 12/31/2014 12/31/2999Q0163 00185064801 12/31/2999 12/31/2999Q0163 00185064810 12/31/2999 12/31/2999Q0163 00185064901 12/31/2999 12/31/2999Q0163 00185064910 12/31/2999 12/31/2999Q0163 00363002405 12/31/2999 12/31/2999Q0163 00363010612 12/31/2999 12/31/2999Q0163 00363010706 12/31/2999 12/31/2999Q0163 00363010708 12/31/2999 12/31/2999Q0163 00363010722 12/31/2999 12/31/2999Q0163 00363018921 12/31/2999 12/31/2999Q0163 00363029908 12/31/2999 12/31/2999Q0163 00363032908 12/31/2999 12/31/2999Q0163 00363032912 12/31/2999 12/31/2999Q0163 00363032922 12/31/2999 12/31/2999Q0163 00363036708 12/31/2999 12/31/2999Q0163 00363037926 12/31/2999 12/31/2999Q0163 00363037934 12/31/2999 12/31/2999Q0163 00440742512 12/31/2999 12/31/2999Q0163 00450010825 12/31/2999 12/31/2999Q0163 00450010849 12/31/2999 12/31/2999Q0163 00450018018 12/31/2999 12/31/2999Q0163 00450019018 12/31/2999 12/31/2999Q0163 00450084310 12/31/2999 12/31/2999Q0163 00450084324 12/31/2999 12/31/2999Q0163 00501204910 12/31/2999 12/31/2999Q0163 00536077085 12/31/2999 12/31/2999

Page 223: *This document is a compilation of NDC:HCPCS combinations

Q0163 00536077097 12/31/2999 12/31/2999Q0163 00536359401 12/31/2999 12/31/2999Q0163 00536359701 12/31/2999 12/31/2999Q0163 00536377206 12/31/2999 12/31/2999Q0163 00555005902 12/31/2999 12/31/2999Q0163 00555005905 12/31/2999 12/31/2999Q0163 00573341210 12/31/2999 4/10/2012Q0163 00573341215 12/31/2999 4/10/2012Q0163 00603024118 12/31/2999 12/31/2999Q0163 00603082354 12/31/2999 12/31/2999Q0163 00603082358 12/31/2999 12/31/2999Q0163 00603082381 12/31/2999 12/31/2999Q0163 00603082394 12/31/2999 12/31/2999Q0163 00603086054 12/31/2999 12/31/2999Q0163 00603333921 12/31/2999 12/31/2999Q0163 00603333932 12/31/2999 12/31/2999Q0163 00603334021 12/31/2999 12/31/2999Q0163 00603334032 12/31/2999 12/31/2999Q0163 00904122800 12/31/2999 12/31/2999Q0163 00904122820 12/31/2999 12/31/2999Q0163 00904203524 12/31/2999 12/31/2999Q0163 00904203559 12/31/2999 12/31/2999Q0163 00904205661 12/31/2999 12/31/2999Q0163 00904427451 12/31/2999 12/31/2999Q0163 00904517416 12/31/2999 12/31/2999Q0163 00904530660 12/31/2999 12/31/2999Q0163 00904530661 12/31/2999 12/31/2999Q0163 00904530680 12/31/2999 12/31/2999Q0163 00904530760 12/31/2999 12/31/2999Q0163 00904530780 12/31/2999 12/31/2999Q0163 00904555124 12/31/2999 12/31/2999Q0163 00904555159 12/31/2999 12/31/2999Q0163 10135014901 12/31/2999 12/31/2999Q0163 10135014910 12/31/2999 12/31/2999Q0163 10135014924 12/31/2999 12/31/2999Q0163 10135015101 12/31/2999 12/31/2999Q0163 10135015110 12/31/2999 12/31/2999Q0163 10135015124 12/31/2999 12/31/2999Q0163 10135015150 12/31/2999 12/31/2999Q0163 10135015152 12/31/2999 12/31/2999Q0163 10135015157 12/31/2999 12/31/2999Q0163 10135015601 12/31/2999 12/31/2999Q0163 10135015610 12/31/2999 12/31/2999Q0163 10135015613 12/31/2999 12/31/2999Q0163 10135016613 12/31/2999 12/31/2999Q0163 10267083501 12/31/2999 12/31/2999Q0163 10267083504 12/31/2999 12/31/2999

Page 224: *This document is a compilation of NDC:HCPCS combinations

Q0163 10267083601 12/31/2999 12/31/2999Q0163 10267083604 12/31/2999 12/31/2999Q0163 10892011265 12/31/2999 4/4/2011Q0163 10939006722 12/31/2999 12/31/2999Q0163 10939006822 12/31/2999 12/31/2999Q0163 10939007422 12/31/2999 12/31/2999Q0163 10939009101 12/31/2999 12/31/2999Q0163 10939009111 12/31/2999 12/31/2999Q0163 10939009211 12/31/2999 12/31/2999Q0163 10939015301 12/31/2999 12/31/2999Q0163 10939025422 12/31/2999 12/31/2999Q0163 10939025522 12/31/2999 12/31/2999Q0163 10939045733 12/31/2999 12/31/2999Q0163 10939046633 12/31/2999 12/31/2999Q0163 10939046733 12/31/2999 12/31/2999Q0163 10939048933 12/31/2999 12/31/2999Q0163 10939049133 12/31/2999 12/31/2999Q0163 10939049233 12/31/2999 12/31/2999Q0163 10939049533 12/31/2999 12/31/2999Q0163 10939049633 12/31/2999 12/31/2999Q0163 10939049833 12/31/2999 12/31/2999Q0163 10939050233 12/31/2999 12/31/2999Q0163 10939056401 12/31/2999 12/31/2999Q0163 10939056411 12/31/2999 12/31/2999Q0163 10939056601 12/31/2999 12/31/2999Q0163 10939056611 12/31/2999 12/31/2999Q0163 10939078722 12/31/2999 12/31/2999Q0163 11383007930 12/31/2999 12/31/2999Q0163 11383011825 12/31/2999 12/31/2999Q0163 11383011850 12/31/2999 12/31/2999Q0163 11383013711 12/31/2999 12/31/2999Q0163 11383013750 12/31/2999 12/31/2999Q0163 11383017908 12/31/2999 12/31/2999Q0163 11673031013 12/31/2999 12/31/2999Q0163 11673037926 12/31/2999 12/31/2999Q0163 11822002070 12/31/2999 12/31/2999Q0163 11822002090 12/31/2999 12/31/2999Q0163 11822303990 12/31/2999 12/31/2999Q0163 11822304050 12/31/2999 12/31/2999Q0163 11822304090 12/31/2999 12/31/2999Q0163 11822305800 12/31/2999 12/31/2999Q0163 11822317290 12/31/2999 12/31/2999Q0163 11822332050 12/31/2999 12/31/2999Q0163 11822332090 12/31/2999 12/31/2999Q0163 11822382310 12/31/2999 12/31/2999Q0163 11822389470 12/31/2999 12/31/2999Q0163 11822454350 12/31/2999 12/31/2999

Page 225: *This document is a compilation of NDC:HCPCS combinations

Q0163 11822505960 12/31/2999 12/31/2999Q0163 11822527100 12/31/2999 7/13/2011Q0163 11845089601 12/31/2999 12/31/2999Q0163 11845092001 12/31/2999 4/4/2011Q0163 11917001146 12/31/2999 12/31/2999Q0163 11917001957 12/31/2999 12/31/2999Q0163 11917002391 12/31/2999 12/31/2999Q0163 11917003657 12/31/2999 12/31/2999Q0163 11917003658 12/31/2999 12/31/2999Q0163 11917004173 12/31/2999 12/31/2999Q0163 11917004388 12/31/2999 12/31/2999Q0163 11917004389 12/31/2999 12/31/2999Q0163 11917004397 12/31/2999 12/31/2999Q0163 11917004460 12/31/2999 12/31/2999Q0163 11917004463 12/31/2999 12/31/2999Q0163 11917007188 12/31/2999 12/31/2999Q0163 11917007190 12/31/2999 12/31/2999Q0163 11917007191 12/31/2999 12/31/2999Q0163 11917007193 12/31/2999 12/31/2999Q0163 11917007194 12/31/2999 12/31/2999Q0163 11917008099 12/31/2999 12/31/2999Q0163 11917009777 12/31/2999 12/31/2999Q0163 11917010244 12/31/2999 12/31/2999Q0163 12547017021 12/31/2999 12/31/2999Q0163 12547017031 12/31/2999 12/31/2999Q0163 12547017033 12/31/2999 12/31/2999Q0163 12547017136 12/31/2999 12/31/2999Q0163 12547017540 12/31/2999 12/31/2999Q0163 15127025816 12/31/2999 12/31/2999Q0163 15127028324 12/31/2999 12/31/2999Q0163 15127028348 12/31/2999 12/31/2999Q0163 15127050404 12/31/2999 12/31/2999Q0163 16103034711 12/31/2999 12/31/2999Q0163 16103034811 12/31/2999 12/31/2999Q0163 16590007820 12/31/2999 12/31/2999Q0163 16590007920 12/31/2999 12/31/2999Q0163 21695030420 12/31/2999 12/31/2999Q0163 21695030430 12/31/2999 12/31/2999Q0163 21695030490 12/31/2999 12/31/2999Q0163 21695050015 12/31/2999 12/31/2999Q0163 21695050030 12/31/2999 12/31/2999Q0163 21695068904 12/31/2999 12/31/2999Q0163 23490545501 12/31/2999 12/31/2999Q0163 23490545700 12/31/2999 12/31/2999Q0163 23490545701 12/31/2999 12/31/2999Q0163 23490545702 12/31/2999 12/31/2999Q0163 23490545703 12/31/2999 12/31/2999

Page 226: *This document is a compilation of NDC:HCPCS combinations

Q0163 23490545704 12/31/2999 12/31/2999Q0163 23490545705 12/31/2999 12/31/2999Q0163 23490545901 12/31/2999 12/31/2999Q0163 23490545902 12/31/2999 12/31/2999Q0163 23490545903 12/31/2999 12/31/2999Q0163 23490545904 12/31/2999 12/31/2999Q0163 24385037926 12/31/2999 12/31/2999Q0163 24385043126 12/31/2999 12/31/2999Q0163 24385043178 12/31/2999 12/31/2999Q0163 24385046262 12/31/2999 12/31/2999Q0163 24385046278 12/31/2999 12/31/2999Q0163 24385047962 12/31/2999 12/31/2999Q0163 24385047978 12/31/2999 12/31/2999Q0163 30142037926 12/31/2999 12/31/2999Q0163 30142047962 12/31/2999 12/31/2999Q0163 32363007930 12/31/2999 12/31/2999Q0163 32363011825 12/31/2999 12/31/2999Q0163 32363011850 12/31/2999 12/31/2999Q0163 32363013710 12/31/2999 12/31/2999Q0163 32363013750 12/31/2999 12/31/2999Q0163 32363017908 12/31/2999 12/31/2999Q0163 33358011120 12/31/2999 12/31/2999Q0163 33358011130 12/31/2999 12/31/2999Q0163 35515094576 12/31/2999 12/31/2999Q0163 35515094577 12/31/2999 12/31/2999Q0163 35515094579 12/31/2999 12/31/2999Q0163 35515095330 12/31/2999 12/31/2999Q0163 35515095673 12/31/2999 12/31/2999Q0163 37205012064 12/31/2999 12/31/2999Q0163 37205019462 12/31/2999 12/31/2999Q0163 37205027062 12/31/2999 12/31/2999Q0163 37205027078 12/31/2999 12/31/2999Q0163 37205027762 12/31/2999 12/31/2999Q0163 37205027778 12/31/2999 12/31/2999Q0163 37205056526 12/31/2999 12/31/2999Q0163 37205056534 12/31/2999 12/31/2999Q0163 37864074501 12/31/2999 4/1/2010Q0163 40986001070 12/31/2999 12/31/2999Q0163 40986001396 12/31/2999 12/31/2999Q0163 40986001397 12/31/2999 12/31/2999Q0163 40986001456 12/31/2999 12/31/2999Q0163 40986001457 12/31/2999 12/31/2999Q0163 40986001458 12/31/2999 12/31/2999Q0163 40986001466 12/31/2999 12/31/2999Q0163 40986001485 12/31/2999 12/31/2999Q0163 40986001486 12/31/2999 12/31/2999Q0163 40986001487 12/31/2999 12/31/2999

Page 227: *This document is a compilation of NDC:HCPCS combinations

Q0163 40986002160 12/31/2999 12/31/2999Q0163 41163002473 12/31/2999 4/13/2011Q0163 41163025100 12/31/2999 12/31/2999Q0163 41163025102 12/31/2999 12/31/2999Q0163 41163025128 12/31/2999 12/31/2999Q0163 41163025178 12/31/2999 12/31/2999Q0163 41163025529 12/31/2999 12/31/2999Q0163 41163025674 12/31/2999 12/31/2999Q0163 41163026545 12/31/2999 12/31/2999Q0163 41163037926 12/31/2999 12/31/2999Q0163 41163037934 12/31/2999 12/31/2999Q0163 41163043162 12/31/2999 12/31/2999Q0163 41163046262 12/31/2999 12/31/2999Q0163 41163046278 12/31/2999 12/31/2999Q0163 41163047962 12/31/2999 12/31/2999Q0163 41163047978 12/31/2999 12/31/2999Q0163 41415016473 12/31/2999 12/31/2999Q0163 43063018506 12/31/2999 12/31/2999Q0163 43292055631 12/31/2999 12/31/2999Q0163 43292055705 12/31/2999 12/31/2999Q0163 43292055719 12/31/2999 12/31/2999Q0163 43292055765 12/31/2999 12/31/2999Q0163 43292055778 12/31/2999 12/31/2999Q0163 47682018247 12/31/2999 1/1/2012Q0163 47682018264 12/31/2999 1/1/2012Q0163 47682085887 12/31/2999 1/1/2012Q0163 49348004534 12/31/2999 12/31/2999Q0163 49348007406 12/31/2999 12/31/2999Q0163 49348020537 12/31/2999 12/31/2999Q0163 49348028208 12/31/2999 12/31/2999Q0163 49348047104 12/31/2999 12/31/2999Q0163 49614014662 12/31/2999 12/31/2999Q0163 49614037926 12/31/2999 12/31/2999Q0163 49614046262 12/31/2999 12/31/2999Q0163 49614046278 12/31/2999 12/31/2999Q0163 49999000300 12/31/2999 12/31/2999Q0163 49999000306 12/31/2999 12/31/2999Q0163 49999000315 12/31/2999 12/31/2999Q0163 49999000320 12/31/2999 12/31/2999Q0163 49999000321 12/31/2999 12/31/2999Q0163 49999000324 12/31/2999 12/31/2999Q0163 49999000330 12/31/2999 12/31/2999Q0163 49999000340 12/31/2999 12/31/2999Q0163 49999000360 12/31/2999 12/31/2999Q0163 49999009104 12/31/2999 4/4/2011Q0163 49999009115 12/31/2999 12/31/2999Q0163 49999009120 12/31/2999 12/31/2999

Page 228: *This document is a compilation of NDC:HCPCS combinations

Q0163 49999009130 12/31/2999 4/4/2011Q0163 49999009160 12/31/2999 12/31/2999Q0163 50428013847 12/31/2999 12/31/2999Q0163 50428155756 12/31/2999 12/31/2999Q0163 50428209650 12/31/2999 12/31/2999Q0163 50428232567 12/31/2999 3/12/2011Q0163 50428244958 12/31/2999 12/31/2999Q0163 50428303719 12/31/2999 12/31/2999Q0163 50428310452 12/31/2999 6/4/2012Q0163 50428477066 12/31/2999 12/31/2999Q0163 50428477068 12/31/2999 12/31/2999Q0163 50428477069 12/31/2999 12/31/2999Q0163 50428477070 12/31/2999 12/31/2999Q0163 50428477071 12/31/2999 12/31/2999Q0163 50428477072 12/31/2999 12/31/2999Q0163 50428477073 12/31/2999 12/31/2999Q0163 50428661736 12/31/2999 12/31/2999Q0163 50428694766 12/31/2999 12/31/2999Q0163 50428864199 12/31/2999 12/31/2999Q0163 50580022610 12/31/2999 12/31/2999Q0163 50580022624 12/31/2999 12/31/2999Q0163 50580022648 12/31/2999 12/31/2999Q0163 50580022824 12/31/2999 12/31/2999Q0163 50580034718 12/31/2999 12/31/2999Q0163 50580051224 12/31/2999 12/31/2008Q0163 50580051248 12/31/2999 12/31/2008Q0163 50580053404 12/31/2999 12/31/2999Q0163 50580053408 12/31/2999 12/31/2999Q0163 50580053504 12/31/2999 5/31/2012Q0163 50580058025 12/31/2999 12/31/2999Q0163 50580058049 12/31/2999 12/31/2999Q0163 50580084310 12/31/2999 12/31/2999Q0163 50580084324 12/31/2999 12/31/2999Q0163 50580084372 12/31/2999 12/31/2008Q0163 51079006601 5/31/2013 8/30/2011Q0163 51079006620 5/31/2013 8/30/2011Q0163 51079096701 12/31/2999 5/16/2012Q0163 51079096717 12/31/2999 5/16/2012Q0163 51645074501 12/31/2999 4/1/2010Q0163 51655008824 12/31/2999 9/25/2007Q0163 51655008852 12/31/2999 9/25/2007Q0163 52959004300 12/31/2999 12/31/2999Q0163 52959004304 12/31/2999 12/31/2999Q0163 52959004310 12/31/2999 12/31/2999Q0163 52959004315 12/31/2999 12/31/2999Q0163 52959004320 12/31/2999 12/31/2999Q0163 52959004324 12/31/2999 12/31/2999

Page 229: *This document is a compilation of NDC:HCPCS combinations

Q0163 52959004330 12/31/2999 12/31/2999Q0163 52959004350 12/31/2999 12/31/2999Q0163 52959004360 12/31/2999 4/4/2011Q0163 52959005306 12/31/2999 4/4/2011Q0163 52959005310 12/31/2999 4/4/2011Q0163 52959005312 12/31/2999 4/4/2011Q0163 52959005315 12/31/2999 4/4/2011Q0163 52959005320 12/31/2999 4/4/2011Q0163 52959005330 12/31/2999 4/4/2011Q0163 52959005352 12/31/2999 4/4/2011Q0163 52959012303 12/31/2999 12/31/2999Q0163 52959012306 12/31/2999 12/31/2999Q0163 53807015403 12/31/2999 12/31/2999Q0163 53807015408 12/31/2999 12/31/2999Q0163 53807015416 12/31/2999 12/31/2999Q0163 53807016001 12/31/2999 12/31/2999Q0163 53807016003 12/31/2999 12/31/2999Q0163 53807016004 12/31/2999 12/31/2999Q0163 53807020404 12/31/2999 12/31/2999Q0163 53807020408 12/31/2999 12/31/2999Q0163 53807020416 12/31/2999 12/31/2999Q0163 53807020428 12/31/2999 12/31/2999Q0163 54257071414 12/31/2999 12/31/2999Q0163 54257071417 12/31/2999 12/31/2999Q0163 54257076515 12/31/2999 12/31/2999Q0163 54569023900 12/31/2999 12/31/2999Q0163 54569023901 12/31/2999 12/31/2999Q0163 54569023902 12/31/2999 8/30/2011Q0163 54569023903 12/31/2999 12/31/2999Q0163 54569023908 12/31/2999 5/12/2006Q0163 54569024100 12/31/2999 4/4/2011Q0163 54569024102 12/31/2999 12/31/2999Q0163 54569024103 12/31/2999 12/31/2999Q0163 54569024105 12/31/2999 4/4/2011Q0163 54569350400 12/31/2999 12/31/2999Q0163 54569350401 12/31/2999 12/31/2999Q0163 54569419700 12/31/2999 12/31/2999Q0163 54738011501 12/31/2999 4/1/2007Q0163 54738011503 12/31/2999 9/1/2006Q0163 54738011513 12/31/2999 12/31/2999Q0163 54738011601 12/31/2999 2/1/2007Q0163 54738011603 12/31/2999 7/1/2007Q0163 54738011613 12/31/2999 12/31/2999Q0163 54838013540 12/31/2999 12/31/2999Q0163 54838013570 12/31/2999 12/31/2999Q0163 54838013580 12/31/2999 12/31/2999Q0163 54838015440 12/31/2999 12/31/2999

Page 230: *This document is a compilation of NDC:HCPCS combinations

Q0163 54838015470 12/31/2999 12/31/2999Q0163 54838015480 12/31/2999 12/31/2999Q0163 54868002600 12/31/2999 12/31/2999Q0163 54868002601 12/31/2999 12/31/2999Q0163 54868002604 12/31/2999 12/31/2999Q0163 54868002605 12/31/2999 12/31/2999Q0163 54868002606 12/31/2999 12/31/2999Q0163 54868002607 12/31/2999 8/30/2011Q0163 54868105000 12/31/2999 6/30/2011Q0163 54868105001 12/31/2999 12/31/2999Q0163 54868105003 12/31/2999 6/30/2011Q0163 54868105004 12/31/2999 6/30/2011Q0163 54868105005 12/31/2999 12/31/2999Q0163 54868122700 12/31/2999 12/31/2999Q0163 54868122702 12/31/2999 12/31/2999Q0163 55045112400 12/31/2999 10/7/2009Q0163 55045112405 12/31/2999 10/7/2009Q0163 55045112408 12/31/2999 10/7/2009Q0163 55289010001 12/31/2999 8/30/2011Q0163 55289010010 12/31/2999 8/30/2011Q0163 55289010015 12/31/2999 8/30/2011Q0163 55289010020 12/31/2999 8/30/2011Q0163 55289010030 12/31/2999 8/30/2011Q0163 55289010040 12/31/2999 8/30/2011Q0163 55289047901 12/31/2999 12/31/2999Q0163 55289047910 12/31/2999 12/31/2999Q0163 55289047912 12/31/2999 12/31/2999Q0163 55289047915 12/31/2999 12/31/2999Q0163 55289047920 12/31/2999 12/31/2999Q0163 55289047924 12/31/2999 12/31/2999Q0163 55289047930 12/31/2999 12/31/2999Q0163 55887088520 12/31/2999 4/1/2007Q0163 56062046262 12/31/2999 12/31/2999Q0163 58016040806 12/31/2999 11/29/2012Q0163 58016040810 12/31/2999 11/29/2012Q0163 58016040815 12/31/2999 11/29/2012Q0163 58016040820 12/31/2999 11/29/2012Q0163 58016040830 12/31/2999 11/29/2012Q0163 58016040860 12/31/2999 11/29/2012Q0163 58016040900 12/31/2999 8/30/2011Q0163 58016040910 12/31/2999 8/30/2011Q0163 58016040912 12/31/2999 8/30/2011Q0163 58016040915 12/31/2999 8/30/2011Q0163 58016040920 12/31/2999 8/30/2011Q0163 58016040924 12/31/2999 8/30/2011Q0163 58016040930 12/31/2999 8/30/2011Q0163 58016040960 12/31/2999 11/29/2012

Page 231: *This document is a compilation of NDC:HCPCS combinations

Q0163 58016040990 12/31/2999 11/29/2012Q0163 58864016230 12/31/2999 12/31/2999Q0163 58864016256 12/31/2999 12/31/2999Q0163 60242020201 12/31/2999 9/11/2009Q0163 60242020210 12/31/2999 9/11/2009Q0163 60760033030 12/31/2999 4/4/2011Q0163 63629134301 12/31/2999 12/31/2999Q0163 63629134302 12/31/2999 12/31/2999Q0163 63629134303 12/31/2999 12/31/2999Q0163 63629134304 12/31/2999 12/31/2999Q0163 63868008701 12/31/2999 12/31/2999Q0163 63868008724 12/31/2999 12/31/2999Q0163 63868050001 12/31/2999 12/31/2999Q0163 63868050024 12/31/2999 12/31/2999Q0163 63868061132 12/31/2999 12/31/2999Q0163 63868061232 12/31/2999 12/31/2999Q0163 63868078924 12/31/2999 12/31/2999Q0163 63868082354 12/31/2999 12/31/2999Q0163 66267008015 12/31/2999 12/31/2999Q0163 66267008020 12/31/2999 12/31/2999Q0163 66267008030 12/31/2999 12/31/2999Q0163 66267008060 12/31/2999 12/31/2999Q0163 66267008115 12/31/2999 12/31/2999Q0163 66267008120 12/31/2999 4/4/2011Q0163 66267008130 12/31/2999 4/4/2011Q0163 66267008160 12/31/2999 12/31/2999Q0163 66267097704 12/31/2999 12/31/2999Q0163 66336058930 12/31/2999 12/31/2999Q0163 66424002001 12/31/2999 12/31/2999Q0163 66424002010 12/31/2999 12/31/2999Q0163 66424002101 12/31/2999 12/31/2999Q0163 66424002110 12/31/2999 12/31/2999Q0163 68016001456 12/31/2999 12/31/2999Q0163 68016001457 12/31/2999 12/31/2999Q0163 68016001458 12/31/2999 5/2/2012Q0163 68016001466 12/31/2999 12/31/2999Q0163 68016001485 12/31/2999 12/31/2999Q0163 68016001486 12/31/2999 12/31/2999Q0163 68016001487 12/31/2999 12/31/2999Q0163 68016002160 12/31/2999 12/31/2999Q0163 68016027706 12/31/2999 12/31/2999Q0163 68016082354 12/31/2999 1/13/2012Q0163 68016082356 12/31/2999 1/13/2012Q0163 68387054130 12/31/2999 4/4/2011Q0163 70030013015 12/31/2999 12/31/2999Q0163 70030013133 12/31/2999 12/31/2999Q0163 70030013264 12/31/2999 12/31/2999

Page 232: *This document is a compilation of NDC:HCPCS combinations

Q0163 70030013971 12/31/2999 12/31/2999Q0163 70030062166 12/31/2999 11/8/2012Q0163 74300000133 12/31/2999 12/31/2999Q0163 74300000610 12/31/2999 12/31/2999Q0163 74300000611 12/31/2999 12/31/2999Q0163 75137021215 12/31/2999 12/31/2999Q0163 81131069983 12/31/2999 12/31/2999Q0163 81131077909 12/31/2999 12/31/2999Q0163 87701040311 12/31/2999 12/31/2999Q0163 87701064954 12/31/2999 12/31/2999Q0163 87701064955 12/31/2999 12/31/2999Q0163 87701083623 12/31/2999 12/31/2999Q0163 87701083714 12/31/2999 12/31/2999Q0163 87701089865 12/31/2999 12/31/2999Q0163 87701094174 12/31/2999 12/31/2999Q0163 91899014662 12/31/2999 12/31/2999Q0163 96295011355 12/31/2999 12/31/2999Q0163 97882000105 12/31/2999 11/8/2012Q0164 00093964301 12/31/2999 12/31/2999Q0164 00093965201 12/31/2999 12/31/2999Q0164 00378510501 12/31/2999 12/31/2999Q0164 00378511001 12/31/2999 12/31/2999Q0164 00440219012 12/31/2999 12/31/2999Q0164 00781502001 12/31/2999 12/31/2999Q0164 00781502101 12/31/2999 12/31/2999Q0164 10135036701 12/31/2999 12/31/2999Q0164 10135036801 12/31/2999 12/31/2999Q0164 21695057130 12/31/2999 12/31/2999Q0164 23490651201 12/31/2999 12/31/2999Q0164 23490651202 12/31/2999 12/31/2999Q0164 33358029920 12/31/2999 12/31/2999Q0164 33358029930 12/31/2999 12/31/2999Q0164 51079054101 12/31/2999 12/31/2999Q0164 51079054120 12/31/2999 12/31/2999Q0164 51079054201 12/31/2999 12/31/2999Q0164 51079054220 12/31/2999 12/31/2999Q0164 52959051110 12/31/2999 12/31/2999Q0164 52959051115 12/31/2999 12/31/2999Q0164 54569035005 12/31/2999 12/31/2999Q0164 54569035500 12/31/2999 12/31/2999Q0164 54569035502 12/31/2999 12/31/2999Q0164 54868472100 12/31/2999 12/31/2999Q0164 54868472101 12/31/2999 12/31/2999Q0164 54868472102 12/31/2999 6/30/2011Q0164 54868472103 12/31/2999 6/30/2011Q0164 55289056810 12/31/2999 12/31/2999Q0164 55289056812 12/31/2999 12/31/2999

Page 233: *This document is a compilation of NDC:HCPCS combinations

Q0164 55289056820 12/31/2999 12/31/2999Q0164 55289056830 12/31/2999 12/31/2999Q0164 58016032612 12/31/2999 11/29/2012Q0164 58016032630 12/31/2999 11/29/2012Q0164 59746011306 12/31/2999 12/31/2999Q0164 60429016202 12/31/2999 12/31/2999Q0164 66267027112 12/31/2999 12/31/2999Q0165 00093965201 12/31/2999 12/31/2999Q0165 00378511001 12/31/2999 12/31/2999Q0165 00440219012 12/31/2999 12/31/2999Q0165 00781502101 12/31/2999 12/31/2999Q0165 10135036701 12/31/2999 12/31/2999Q0165 10135036801 12/31/2999 12/31/2999Q0165 21695057130 12/31/2999 12/31/2999Q0165 21695057230 12/31/2999 12/31/2999Q0165 23490650903 12/31/2999 12/31/2999Q0165 23490651201 12/31/2999 12/31/2999Q0165 23490651202 12/31/2999 12/31/2999Q0165 33358029920 12/31/2999 12/31/2999Q0165 33358029930 12/31/2999 12/31/2999Q0165 33358030010 12/31/2999 12/31/2999Q0165 33358030020 12/31/2999 12/31/2999Q0165 33358030030 12/31/2999 12/31/2999Q0165 33358030060 12/31/2999 12/31/2999Q0165 35356032500 12/31/2999 12/31/2999Q0165 35356032505 12/31/2999 12/31/2999Q0165 43063016004 12/31/2999 12/31/2999Q0165 43063016006 12/31/2999 12/31/2999Q0165 51079054101 12/31/2999 12/31/2999Q0165 51079054201 12/31/2999 12/31/2999Q0165 51079054220 12/31/2999 12/31/2999Q0165 51285052202 12/31/2999 12/17/2001Q0165 51285052204 12/31/2999 7/10/2002Q0165 51991019701 12/31/2999 8/31/2008Q0165 52959047602 12/31/2999 12/31/2999Q0165 52959047610 12/31/2999 12/31/2999Q0165 52959047615 12/31/2999 12/31/2999Q0165 52959047620 12/31/2999 12/31/2999Q0165 52959047624 12/31/2999 12/31/2999Q0165 52959047630 12/31/2999 12/31/2999Q0165 52959047660 12/31/2999 12/31/2999Q0165 54569035100 12/31/2999 1/31/2003Q0165 54569035500 12/31/2999 12/31/2999Q0165 54569035501 12/31/2999 6/1/2003Q0165 54569035502 12/31/2999 12/31/2999Q0165 54569035503 12/31/2999 6/1/2002Q0165 54868108200 12/31/2999 12/31/2999

Page 234: *This document is a compilation of NDC:HCPCS combinations

Q0165 54868108201 12/31/2999 12/31/2999Q0165 54868108202 12/31/2999 12/31/2999Q0165 54868108203 12/31/2999 6/30/2012Q0165 54868108204 12/31/2999 12/31/2999Q0165 54868108205 12/31/2999 12/31/2999Q0165 54868108206 12/31/2999 12/31/2999Q0165 54868472102 12/31/2999 6/30/2011Q0165 54868472103 12/31/2999 6/30/2011Q0165 55045112603 12/31/2999 10/7/2009Q0165 55045112606 12/31/2999 10/7/2009Q0165 55045112608 12/31/2999 10/7/2009Q0165 55045207403 12/31/2999 1/1/2003Q0165 55045207404 12/31/2999 1/1/2003Q0165 55045207407 12/31/2999 1/1/2003Q0165 55289022406 12/31/2999 12/31/2999Q0165 55289022412 12/31/2999 12/31/2999Q0165 55289056810 12/31/2999 12/31/2999Q0165 55289056820 12/31/2999 12/31/2999Q0165 55289056830 12/31/2999 12/31/2999Q0165 55887061930 12/31/2999 7/25/2008Q0165 58016070600 12/31/2999 11/29/2012Q0165 58016070602 12/31/2999 11/29/2012Q0165 58016070603 12/31/2999 11/29/2012Q0165 58016070630 12/31/2999 11/29/2012Q0165 58016070660 12/31/2999 11/29/2012Q0165 58016070690 12/31/2999 11/29/2012Q0165 58864064442 12/31/2999 12/31/2999Q0165 59746011506 12/31/2999 12/31/2999Q0165 60346043410 12/31/2999 5/9/2001Q0165 60346086015 12/31/2999 5/9/2001Q0165 60346086025 12/31/2999 5/9/2001Q0165 60346086030 12/31/2999 5/9/2001Q0165 60429016202 12/31/2999 12/31/2999Q0165 63629133501 12/31/2999 12/31/2999Q0165 63629133502 12/31/2999 12/31/2999Q0165 63629133503 12/31/2999 12/31/2999Q0165 66116022620 12/31/2999 1/1/2007Q0165 66267031830 12/31/2999 12/31/2999Q0165 66993081005 12/31/2999 12/31/2008Q0165 68115029812 12/31/2999 4/1/2009Q0165 68115029830 12/31/2999 4/1/2009Q0165 68115029860 12/31/2999 4/1/2009Q0166 00054014308 12/31/2999 12/31/2999Q0166 00054014387 12/31/2999 12/31/2999Q0166 00093748512 12/31/2999 12/31/2999Q0166 00093748520 12/31/2999 12/31/2999Q0166 16714022101 12/31/2020 12/31/2999

Page 235: *This document is a compilation of NDC:HCPCS combinations

Q0166 16714022130 12/31/2020 12/31/2999Q0166 16714022132 12/31/2020 12/31/2999Q0166 51672413806 12/31/2999 12/31/2999Q0166 67877018402 12/31/2999 8/1/2011Q0166 67877018420 12/31/2999 8/1/2011Q0167 00051002121 12/31/2999 12/31/2999Q0167 00051002221 12/31/2999 12/31/2999Q0167 00051002321 12/31/2999 12/31/2999Q0167 00378817091 12/31/2999 12/31/2999Q0167 00378817191 12/31/2999 12/31/2999Q0167 00378817291 12/31/2999 12/31/2999Q0167 00591359160 12/31/2999 12/31/2999Q0167 00591359260 12/31/2999 12/31/2999Q0167 00591359360 12/31/2999 12/31/2999Q0167 49884086702 12/31/2999 12/31/2999Q0167 49884086802 12/31/2999 12/31/2999Q0167 49884086902 12/31/2999 12/31/2999Q0167 54569578900 12/31/2999 4/30/2008Q0167 54868308400 12/31/2999 12/31/2999Q0167 54868308401 12/31/2999 12/31/2999Q0167 54868308402 12/31/2999 6/30/2011Q0167 54868318900 12/31/2999 6/30/2011Q0167 54868318901 12/31/2999 6/30/2011Q0167 54868318902 12/31/2999 6/30/2011Q0167 68084017401 12/31/2999 12/31/2999Q0167 68084017411 12/31/2999 12/31/2999Q0167 68084017521 12/31/2999 12/31/2999Q0168 00051002221 12/31/2999 12/31/2999Q0168 00051002321 12/31/2999 12/31/2999Q0168 00378817191 12/31/2999 12/31/2999Q0168 00378817291 12/31/2999 12/31/2999Q0168 00591359160 12/31/2999 12/31/2999Q0168 00591359260 12/31/2999 12/31/2999Q0168 00591359360 12/31/2999 12/31/2999Q0168 49884086702 12/31/2999 12/31/2999Q0168 49884086802 12/31/2999 12/31/2999Q0168 49884086902 12/31/2999 12/31/2999Q0168 54868308402 12/31/2999 6/30/2011Q0168 54868318900 12/31/2999 6/30/2011Q0168 54868318901 12/31/2999 6/30/2011Q0168 54868318902 12/31/2999 6/30/2011Q0168 58016095100 12/31/2999 11/29/2012Q0168 58016095130 12/31/2999 11/29/2012Q0168 58016095160 12/31/2999 11/29/2012Q0168 58016095190 12/31/2999 11/29/2012Q0168 68084017401 12/31/2999 12/31/2999Q0168 68084017411 12/31/2999 12/31/2999

Page 236: *This document is a compilation of NDC:HCPCS combinations

Q0168 68084017521 12/31/2999 12/31/2999Q0168 68115069225 12/31/2999 4/1/2009Q0169 00115104001 12/31/2999 12/31/2999Q0169 00115104101 12/31/2999 12/31/2999Q0169 00115104103 12/31/2999 12/31/2999Q0169 00115104201 12/31/2999 12/31/2999Q0169 00378702801 12/31/2999 2/5/2013Q0169 00378702901 2/28/2014 9/25/2012Q0169 00378702910 2/28/2014 9/25/2012Q0169 00378703001 2/28/2014 9/25/2012Q0169 00406204001 12/31/2999 3/27/2009Q0169 00591530701 12/31/2999 12/31/2999Q0169 00591530710 12/31/2999 12/31/2999Q0169 00591531901 12/31/2999 12/31/2999Q0169 00603158454 12/31/2999 12/31/2999Q0169 00603158458 12/31/2999 12/31/2999Q0169 00603543721 12/31/2999 12/31/2999Q0169 00603543821 12/31/2999 12/31/2999Q0169 00603543832 12/31/2999 12/31/2999Q0169 00603543921 12/31/2999 12/31/2999Q0169 00781183001 12/31/2999 12/31/2999Q0169 00781183010 12/31/2999 12/31/2999Q0169 00781183201 12/31/2999 12/31/2999Q0169 00904584061 12/31/2999 12/31/2999Q0169 10135049501 12/31/2999 12/31/2999Q0169 10135049510 12/31/2999 12/31/2999Q0169 10135049601 12/31/2999 12/31/2999Q0169 10702000201 12/31/2999 12/31/2999Q0169 10702000301 12/31/2999 12/31/2999Q0169 10702000310 12/31/2999 12/31/2999Q0169 10702000401 12/31/2999 12/31/2999Q0169 16590019115 12/31/2999 12/31/2999Q0169 16590019130 12/31/2999 12/31/2999Q0169 16590019160 12/31/2999 12/31/2999Q0169 16590019190 12/31/2999 12/31/2999Q0169 21695045310 12/31/2999 12/31/2999Q0169 21695045315 12/31/2999 12/31/2999Q0169 21695045320 12/31/2999 12/31/2999Q0169 21695045325 12/31/2999 12/31/2999Q0169 21695045330 12/31/2999 12/31/2999Q0169 21695058915 12/31/2999 12/31/2999Q0169 21695088510 12/31/2999 12/31/2999Q0169 23490618301 12/31/2999 12/31/2999Q0169 23490618302 12/31/2999 12/31/2999Q0169 23490618303 12/31/2999 12/31/2999Q0169 23490618304 12/31/2999 12/31/2999Q0169 23490618306 12/31/2999 12/31/2999

Page 237: *This document is a compilation of NDC:HCPCS combinations

Q0169 23490618307 12/31/2999 12/31/2999Q0169 23490618308 12/31/2999 12/31/2999Q0169 33358030208 12/31/2999 12/31/2999Q0169 33358030210 12/31/2999 12/31/2999Q0169 33358030230 12/31/2999 12/31/2999Q0169 33358030260 12/31/2999 12/31/2999Q0169 42549054310 12/31/2999 12/31/2999Q0169 42549054320 12/31/2999 12/31/2999Q0169 42549054330 12/31/2999 12/31/2999Q0169 43063004902 12/31/2999 12/31/2999Q0169 43063004906 12/31/2999 12/31/2999Q0169 49999009090 12/31/2999 12/31/2999Q0169 49999029030 12/31/2999 12/31/2999Q0169 49999080220 12/31/2999 4/11/2012Q0169 49999090220 12/31/2999 12/31/2999Q0169 50383080116 12/31/2999 12/31/2999Q0169 51079089520 12/31/2999 12/31/2999Q0169 52959053412 12/31/2999 12/31/2999Q0169 52959053428 12/31/2999 12/31/2999Q0169 52959053460 12/31/2999 12/31/2999Q0169 52959091430 12/31/2999 12/31/2999Q0169 54569104600 12/31/2999 12/31/2999Q0169 54569175400 12/31/2999 12/31/2999Q0169 54569175401 12/31/2999 12/31/2999Q0169 54569175405 12/31/2999 12/31/2999Q0169 54569175406 12/31/2999 12/31/2999Q0169 54569175409 12/31/2999 12/31/2999Q0169 54569416800 12/31/2999 12/31/2999Q0169 54569469900 12/31/2999 1/31/2003Q0169 54868132307 12/31/2999 12/31/2999Q0169 54868132308 12/31/2999 12/31/2999Q0169 54868132309 12/31/2999 12/31/2999Q0169 54868284400 12/31/2999 6/30/2011Q0169 54868284401 12/31/2999 6/30/2011Q0169 54868512100 12/31/2999 12/31/2999Q0169 54868512102 12/31/2999 12/31/2999Q0169 54868512103 12/31/2999 12/31/2999Q0169 54868512104 12/31/2999 12/31/2999Q0169 55289046479 12/31/2999 12/31/2999Q0169 55289053104 12/31/2999 12/31/2999Q0169 55289094802 12/31/2999 12/31/2999Q0169 57664010788 12/31/2999 12/31/2999Q0169 57664010888 12/31/2999 12/31/2999Q0169 57664010988 12/31/2999 12/31/2999Q0169 60346071206 12/31/2999 5/9/2001Q0169 60346071212 12/31/2999 5/9/2001Q0169 60346071244 12/31/2999 5/9/2001

Page 238: *This document is a compilation of NDC:HCPCS combinations

Q0169 60432060804 12/31/2999 12/31/2999Q0169 60432060816 12/31/2999 12/31/2999Q0169 60760083020 12/31/2999 12/31/2999Q0169 60760083030 12/31/2999 12/31/2999Q0169 60760083060 12/31/2999 12/31/2999Q0169 63629159101 12/31/2999 12/31/2999Q0169 63629159102 12/31/2999 12/31/2999Q0169 63629159103 12/31/2999 12/31/2999Q0169 63629159104 12/31/2999 12/31/2999Q0169 63629174201 12/31/2999 12/31/2999Q0169 63629174202 12/31/2999 12/31/2999Q0169 63629174203 12/31/2999 12/31/2999Q0169 63629174204 12/31/2999 12/31/2999Q0169 63629174205 12/31/2999 12/31/2999Q0169 63629174206 12/31/2999 12/31/2999Q0169 63739021310 12/31/2999 12/31/2999Q0169 63739038910 12/31/2999 12/31/2999Q0169 65162052110 12/31/2999 12/31/2999Q0169 65162052111 12/31/2999 12/31/2999Q0169 65162074510 12/31/2999 12/31/2999Q0169 66267017730 12/31/2999 12/31/2999Q0169 68084015401 12/31/2999 12/31/2999Q0169 68084015411 12/31/2999 12/31/2999Q0169 68084015501 12/31/2999 12/31/2999Q0169 68084015511 12/31/2999 12/31/2999Q0169 68382004001 12/31/2999 12/31/2999Q0169 68382004010 12/31/2999 2/27/2007Q0169 68382004101 12/31/2999 12/31/2999Q0169 68382004110 12/31/2999 12/31/2999Q0169 68382004201 12/31/2999 12/31/2999Q0169 68387053612 12/31/2999 12/31/2999Q0169 68387053630 12/31/2999 12/31/2999Q0169 68387053660 12/31/2999 12/31/2999Q0169 68387053690 12/31/2999 12/31/2999Q0170 00115104001 12/31/2999 12/31/2999Q0170 00115104101 12/31/2999 12/31/2999Q0170 00115104103 12/31/2999 12/31/2999Q0170 00115104201 12/31/2999 12/31/2999Q0170 00378702901 2/28/2014 9/25/2012Q0170 00378702910 2/28/2014 9/25/2012Q0170 00378703001 2/28/2014 9/25/2012Q0170 00591530701 12/31/2999 12/31/2999Q0170 00591530710 12/31/2999 12/31/2999Q0170 00591531901 12/31/2999 12/31/2999Q0170 00603158454 12/31/2999 12/31/2999Q0170 00603158458 12/31/2999 12/31/2999Q0170 00603543821 12/31/2999 12/31/2999

Page 239: *This document is a compilation of NDC:HCPCS combinations

Q0170 00603543832 12/31/2999 12/31/2999Q0170 00603543921 12/31/2999 12/31/2999Q0170 00781183001 12/31/2999 12/31/2999Q0170 00781183010 12/31/2999 12/31/2999Q0170 00781183201 12/31/2999 12/31/2999Q0170 00904584061 12/31/2999 12/31/2999Q0170 10135049501 12/31/2999 12/31/2999Q0170 10135049510 12/31/2999 12/31/2999Q0170 10135049601 12/31/2999 12/31/2999Q0170 10544034320 12/31/2999 10/1/2009Q0170 10702000201 12/31/2999 12/31/2999Q0170 10702000301 12/31/2999 12/31/2999Q0170 10702000310 12/31/2999 12/31/2999Q0170 10702000401 12/31/2999 12/31/2999Q0170 16590019115 12/31/2999 12/31/2999Q0170 16590019130 12/31/2999 12/31/2999Q0170 16590019160 12/31/2999 12/31/2999Q0170 16590019190 12/31/2999 12/31/2999Q0170 21695045310 12/31/2999 12/31/2999Q0170 21695045315 12/31/2999 12/31/2999Q0170 21695045320 12/31/2999 12/31/2999Q0170 21695045325 12/31/2999 12/31/2999Q0170 21695045330 12/31/2999 12/31/2999Q0170 21695058915 12/31/2999 12/31/2999Q0170 21695070304 12/31/2999 12/31/2999Q0170 21695088510 12/31/2999 12/31/2999Q0170 23490618301 12/31/2999 12/31/2999Q0170 23490618302 12/31/2999 12/31/2999Q0170 23490618303 12/31/2999 12/31/2999Q0170 23490618304 12/31/2999 12/31/2999Q0170 23490618306 12/31/2999 12/31/2999Q0170 23490618307 12/31/2999 12/31/2999Q0170 23490618308 12/31/2999 12/31/2999Q0170 23490618701 12/31/2999 12/31/2999Q0170 33358030208 12/31/2999 12/31/2999Q0170 33358030210 12/31/2999 12/31/2999Q0170 33358030230 12/31/2999 12/31/2999Q0170 33358030260 12/31/2999 12/31/2999Q0170 42549054310 12/31/2999 12/31/2999Q0170 42549054320 12/31/2999 12/31/2999Q0170 42549054330 12/31/2999 12/31/2999Q0170 43063004902 12/31/2999 12/31/2999Q0170 43063004906 12/31/2999 12/31/2999Q0170 49999009005 12/31/2999 12/31/2999Q0170 49999009010 12/31/2999 12/31/2999Q0170 49999009012 12/31/2999 12/31/2999Q0170 49999009015 12/31/2999 12/31/2999

Page 240: *This document is a compilation of NDC:HCPCS combinations

Q0170 49999009020 12/31/2999 12/31/2999Q0170 49999009030 12/31/2999 12/31/2999Q0170 49999009060 12/31/2999 12/31/2999Q0170 49999009090 12/31/2999 12/31/2999Q0170 49999026204 12/31/2999 12/31/2999Q0170 49999029030 12/31/2999 12/31/2999Q0170 50383080116 12/31/2999 12/31/2999Q0170 51079089520 12/31/2999 12/31/2999Q0170 51655008427 12/31/2999 9/25/2007Q0170 52959053401 12/31/2999 12/31/2999Q0170 52959053402 12/31/2999 12/31/2999Q0170 52959053410 12/31/2999 12/31/2999Q0170 52959053412 12/31/2999 12/31/2999Q0170 52959053415 12/31/2999 12/31/2999Q0170 52959053420 12/31/2999 12/31/2999Q0170 52959053428 12/31/2999 12/31/2999Q0170 52959053430 12/31/2999 12/31/2999Q0170 52959053445 12/31/2999 12/31/2999Q0170 52959053460 12/31/2999 12/31/2999Q0170 52959053490 12/31/2999 12/31/2999Q0170 52959080404 12/31/2999 12/31/2999Q0170 52959080408 12/31/2999 12/31/2999Q0170 54569104600 12/31/2999 12/31/2999Q0170 54569175400 12/31/2999 12/31/2999Q0170 54569175401 12/31/2999 12/31/2999Q0170 54569175405 12/31/2999 12/31/2999Q0170 54569175406 12/31/2999 12/31/2999Q0170 54569175409 12/31/2999 12/31/2999Q0170 54569416800 12/31/2999 12/31/2999Q0170 54868132300 12/31/2999 12/31/2999Q0170 54868132301 12/31/2999 12/31/2999Q0170 54868132302 12/31/2999 12/31/2999Q0170 54868132304 12/31/2999 12/31/2999Q0170 54868132305 12/31/2999 12/31/2999Q0170 54868132306 12/31/2999 12/31/2999Q0170 54868132307 12/31/2999 12/31/2999Q0170 54868132308 12/31/2999 12/31/2999Q0170 54868132309 12/31/2999 12/31/2999Q0170 54868186700 12/31/2999 12/31/2999Q0170 54868284400 12/31/2999 6/30/2011Q0170 54868284401 12/31/2999 6/30/2011Q0170 54868393500 12/31/2999 12/31/2999Q0170 55045159603 12/31/2999 10/7/2009Q0170 55045159605 12/31/2999 10/7/2009Q0170 55045159606 12/31/2999 10/7/2009Q0170 55045159608 12/31/2999 10/7/2009Q0170 55289046402 12/31/2999 12/31/2999

Page 241: *This document is a compilation of NDC:HCPCS combinations

Q0170 55289046410 12/31/2999 12/31/2999Q0170 55289046412 12/31/2999 12/31/2999Q0170 55289046415 12/31/2999 12/31/2999Q0170 55289046420 12/31/2999 12/31/2999Q0170 55289046425 12/31/2999 12/31/2999Q0170 55289046430 12/31/2999 12/31/2999Q0170 55289046460 12/31/2999 12/31/2999Q0170 55289046479 12/31/2999 12/31/2999Q0170 55289053104 12/31/2999 12/31/2999Q0170 55887093615 12/31/2999 7/25/2008Q0170 57664010788 12/31/2999 12/31/2999Q0170 57664010888 12/31/2999 12/31/2999Q0170 57664010988 12/31/2999 12/31/2999Q0170 57664014631 12/31/2999 12/31/2999Q0170 57664014634 12/31/2999 12/31/2999Q0170 57866432803 12/31/2999 5/11/2010Q0170 58016042400 12/31/2999 11/29/2012Q0170 58016042402 12/31/2999 11/29/2012Q0170 58016042403 12/31/2999 11/29/2012Q0170 58016042410 12/31/2999 11/29/2012Q0170 58016042412 12/31/2999 11/29/2012Q0170 58016042415 12/31/2999 11/29/2012Q0170 58016042420 12/31/2999 11/29/2012Q0170 58016042430 12/31/2999 11/29/2012Q0170 58016042450 12/31/2999 11/29/2012Q0170 58016042460 12/31/2999 11/29/2012Q0170 58016042473 12/31/2999 11/29/2012Q0170 58016042489 12/31/2999 11/29/2012Q0170 58016042490 12/31/2999 11/29/2012Q0170 58864076110 12/31/2999 12/31/2999Q0170 58864076130 12/31/2999 12/31/2999Q0170 58864076142 12/31/2999 12/31/2999Q0170 60346008512 12/31/2999 5/9/2001Q0170 60346008520 12/31/2999 5/9/2001Q0170 60346008530 12/31/2999 5/9/2001Q0170 60346008560 12/31/2999 5/9/2001Q0170 60432060804 12/31/2999 12/31/2999Q0170 60432060816 12/31/2999 12/31/2999Q0170 60760083020 12/31/2999 12/31/2999Q0170 60760083030 12/31/2999 12/31/2999Q0170 60760083060 12/31/2999 12/31/2999Q0170 63629174201 12/31/2999 12/31/2999Q0170 63629174202 12/31/2999 12/31/2999Q0170 63629174203 12/31/2999 12/31/2999Q0170 63629174204 12/31/2999 12/31/2999Q0170 63629174205 12/31/2999 12/31/2999Q0170 63629174206 12/31/2999 12/31/2999

Page 242: *This document is a compilation of NDC:HCPCS combinations

Q0170 63629187001 12/31/2999 12/31/2999Q0170 63739021310 12/31/2999 12/31/2999Q0170 63739038910 12/31/2999 12/31/2999Q0170 65162052110 12/31/2999 12/31/2999Q0170 65162052111 12/31/2999 12/31/2999Q0170 66116048830 12/31/2999 1/1/2007Q0170 66267017720 12/31/2999 12/31/2999Q0170 66267017730 12/31/2999 12/31/2999Q0170 68084015501 12/31/2999 12/31/2999Q0170 68084015511 12/31/2999 12/31/2999Q0170 68115030230 12/31/2999 4/1/2009Q0170 68382004101 12/31/2999 12/31/2999Q0170 68382004110 12/31/2999 12/31/2999Q0170 68382004201 12/31/2999 12/31/2999Q0170 68387053612 12/31/2999 12/31/2999Q0170 68387053630 12/31/2999 12/31/2999Q0170 68387053660 12/31/2999 12/31/2999Q0170 68387053690 12/31/2999 12/31/2999Q0171 00781171501 12/31/2999 5/23/2012Q0171 00781171701 12/31/2999 12/21/2011Q0171 00781171801 12/31/2999 5/23/2012Q0171 00781171901 12/31/2999 8/1/2012Q0171 00832030000 12/31/2999 12/31/2999Q0171 00832030010 12/31/2999 7/1/2013Q0171 00832030200 12/31/2999 12/31/2999Q0171 00832030210 12/31/2999 12/31/2999Q0171 00832030300 12/31/2999 12/31/2999Q0171 00832030310 12/31/2999 12/31/2999Q0171 00832030400 12/31/2999 12/31/2999Q0171 00832030410 12/31/2999 12/31/2999Q0171 35356009890 12/31/2999 12/31/2999Q0171 51079013001 12/31/2999 12/31/2999Q0171 51079013020 12/31/2999 12/31/2999Q0171 51079051601 12/31/2999 12/31/2999Q0171 51079051620 12/31/2999 12/31/2999Q0171 51079051701 12/31/2999 12/31/2999Q0171 51079051720 12/31/2999 12/31/2999Q0171 51079051801 12/31/2999 12/31/2999Q0171 51079051820 12/31/2999 12/31/2999Q0171 54868230200 12/31/2999 12/31/2011Q0171 54868230202 12/31/2999 12/31/2011Q0171 54868234700 12/31/2999 6/30/2002Q0171 54868268401 12/31/2999 6/30/2007Q0172 00781171601 12/31/2999 1/25/2012Q0172 00781171701 12/31/2999 12/21/2011Q0172 00781171801 12/31/2999 5/23/2012Q0172 00781171901 12/31/2999 8/1/2012

Page 243: *This document is a compilation of NDC:HCPCS combinations

Q0172 00832030100 12/31/2999 12/31/2999Q0172 00832030110 12/31/2999 12/31/2999Q0172 00832030200 12/31/2999 12/31/2999Q0172 00832030210 12/31/2999 12/31/2999Q0172 00832030300 12/31/2999 12/31/2999Q0172 00832030310 12/31/2999 12/31/2999Q0172 00832030400 12/31/2999 12/31/2999Q0172 00832030410 12/31/2999 12/31/2999Q0172 35356009890 12/31/2999 12/31/2999Q0172 51079013001 12/31/2999 12/31/2999Q0172 51079013020 12/31/2999 12/31/2999Q0172 51079051601 12/31/2999 12/31/2999Q0172 51079051620 12/31/2999 12/31/2999Q0172 51079051701 12/31/2999 12/31/2999Q0172 51079051720 12/31/2999 12/31/2999Q0172 51079051901 12/31/2999 12/31/2999Q0172 51079051920 12/31/2999 12/31/2999Q0172 54868230200 12/31/2999 12/31/2011Q0172 54868230202 12/31/2999 12/31/2011Q0172 54868234700 12/31/2999 6/30/2002Q0172 54868246400 12/31/2999 12/31/2999Q0173 16590057030 12/31/2999 12/31/2999Q0173 16590057060 12/31/2999 12/31/2999Q0173 16590057090 12/31/2999 12/31/2999Q0173 21695044810 12/31/2999 12/31/2999Q0173 35356047300 12/31/2999 12/31/2999Q0173 52959081710 12/31/2999 12/31/2999Q0173 53489037601 12/31/2999 12/31/2999Q0173 54569558900 12/31/2999 12/31/2999Q0173 54569558901 12/31/2999 12/31/2999Q0173 54868518100 12/31/2999 6/30/2011Q0173 54868574100 12/31/2999 6/30/2012Q0173 55289095306 12/31/2999 12/31/2999Q0173 61570007901 12/31/2999 12/31/2999Q0175 00490009100 12/31/2999 11/29/2012Q0175 00490009130 12/31/2999 11/29/2012Q0175 00490009160 12/31/2999 11/29/2012Q0175 00490009190 12/31/2999 11/29/2012Q0175 00603509021 12/31/2013 7/16/2012Q0175 00603509028 11/30/2013 4/17/2012Q0175 00603509121 12/31/2013 4/3/2012Q0175 00603509128 10/31/2013 3/8/2012Q0175 00781104601 12/31/2999 12/31/2999Q0175 00781104613 12/31/2999 12/31/2999Q0175 00781104701 12/31/2999 12/31/2999Q0175 00781104713 12/31/2999 12/31/2999Q0175 21695041460 12/31/2999 12/31/2999

Page 244: *This document is a compilation of NDC:HCPCS combinations

Q0175 54738055101 12/31/2999 10/1/2008Q0175 54738055102 12/31/2999 9/15/2008Q0175 54868268600 12/31/2999 6/30/2002Q0175 62584081701 11/30/2013 8/8/2012Q0175 62584081711 12/31/2999 8/8/2012Q0176 00603509221 12/31/2013 5/8/2012Q0176 00603509228 6/30/2013 5/1/2012Q0176 00603509321 12/31/2013 5/15/2012Q0176 00781104801 12/31/2999 12/31/2999Q0176 00781104813 12/31/2999 12/31/2999Q0176 00781104901 12/31/2999 12/31/2999Q0176 21695041560 12/31/2999 12/31/2999Q0176 35356009660 12/31/2999 12/31/2999Q0176 52959094060 12/31/2999 12/31/2999Q0176 54868268701 12/31/2999 6/30/2010Q0176 54868268702 12/31/2999 6/30/2010Q0176 62584082001 6/30/2013 7/3/2012Q0176 62584082011 12/31/2999 7/3/2012Q0177 00069541066 12/31/2999 12/31/2999Q0177 00185061301 12/31/2999 12/31/2999Q0177 00185061305 12/31/2999 12/31/2999Q0177 00555032302 12/31/2999 12/31/2999Q0177 00555032304 12/31/2999 12/31/2999Q0177 00591080001 12/31/2999 12/31/2999Q0177 00591080005 12/31/2999 12/31/2999Q0177 00591080101 12/31/2999 12/31/2999Q0177 00591080105 12/31/2999 12/31/2999Q0177 21695057320 12/31/2999 12/31/2999Q0177 21695057330 12/31/2999 12/31/2999Q0177 21695057340 12/31/2999 12/31/2999Q0177 23490573301 12/31/2999 12/31/2999Q0177 23490573302 12/31/2999 12/31/2999Q0177 33358018220 12/31/2999 12/31/2999Q0177 33358018230 12/31/2999 12/31/2999Q0177 42549052830 12/31/2999 12/31/2999Q0177 43063017201 12/31/2999 12/31/2999Q0177 43063017204 12/31/2999 12/31/2999Q0177 49999070130 12/31/2999 12/31/2999Q0177 51079007701 12/31/2999 12/31/2999Q0177 51079007720 12/31/2999 12/31/2999Q0177 51079007801 12/31/2999 12/31/2999Q0177 51079007820 12/31/2999 12/31/2999Q0177 52959043310 12/31/2999 12/31/2999Q0177 52959043315 12/31/2999 12/31/2999Q0177 52959043320 12/31/2999 12/31/2999Q0177 52959043330 12/31/2999 12/31/2999Q0177 52959043340 12/31/2999 12/31/2999

Page 245: *This document is a compilation of NDC:HCPCS combinations

Q0177 52959043360 12/31/2999 12/31/2999Q0177 54569235305 12/31/2999 12/31/2999Q0177 54868016901 12/31/2999 6/30/2011Q0177 54868289200 12/31/2999 12/31/2999Q0177 54868289203 12/31/2999 12/31/2999Q0177 54868289204 12/31/2999 12/31/2999Q0177 54868289205 12/31/2999 12/31/2999Q0177 55289022610 12/31/2999 12/31/2999Q0177 55289022615 12/31/2999 12/31/2999Q0177 58016025900 12/31/2999 11/29/2012Q0177 58016025910 12/31/2999 11/29/2012Q0177 58016025920 12/31/2999 11/29/2012Q0177 58016025930 12/31/2999 11/29/2012Q0177 58016025950 12/31/2999 11/29/2012Q0177 58016025960 12/31/2999 11/29/2012Q0177 63629153301 12/31/2999 12/31/2999Q0177 63629153302 12/31/2999 12/31/2999Q0177 66336020830 12/31/2999 12/31/2999Q0177 67544067730 12/31/2999 12/31/2999Q0177 67544067753 12/31/2999 12/31/2999Q0177 67544067760 12/31/2999 12/31/2999Q0177 67544079130 12/31/2999 12/31/2999Q0177 67544079153 12/31/2999 12/31/2999Q0177 67544079160 12/31/2999 12/31/2999Q0178 00069542066 12/31/2999 12/31/2999Q0178 00185061501 12/31/2999 12/31/2999Q0178 00185061505 12/31/2999 12/31/2999Q0178 00555030202 12/31/2999 12/31/2999Q0178 00555030204 12/31/2999 12/31/2999Q0178 00555032402 12/31/2999 12/31/2999Q0178 00591080001 12/31/2999 12/31/2999Q0178 00591080005 12/31/2999 12/31/2999Q0178 00591080101 12/31/2999 12/31/2999Q0178 00591080105 12/31/2999 12/31/2999Q0178 21695057340 12/31/2999 12/31/2999Q0178 43063017201 12/31/2999 12/31/2999Q0178 49999003612 12/31/2999 12/31/2999Q0178 49999003660 12/31/2999 12/31/2999Q0178 51079007701 12/31/2999 12/31/2999Q0178 51079007720 12/31/2999 12/31/2999Q0178 51079007801 12/31/2999 12/31/2999Q0178 51079007820 12/31/2999 12/31/2999Q0178 52959083306 12/31/2999 12/31/2999Q0178 52959083320 12/31/2999 12/31/2999Q0178 54868185400 12/31/2999 6/30/2012Q0178 54868185401 12/31/2999 6/30/2012Q0178 54868185403 12/31/2999 6/30/2012

Page 246: *This document is a compilation of NDC:HCPCS combinations

Q0178 55289035410 12/31/2999 12/31/2999Q0178 58016046410 12/31/2999 11/29/2012Q0178 58016046415 12/31/2999 11/29/2012Q0178 58016046420 12/31/2999 11/29/2012Q0178 58016046430 12/31/2999 11/29/2012Q0178 68387046830 12/31/2999 12/31/2999Q0178 68387046930 12/31/2999 12/31/2999Q0179 00054006447 12/31/2999 12/31/2999Q0179 00093023333 1/31/2014 2/1/2013Q0179 00093023356 12/31/2999 12/31/2999Q0179 00093023393 8/31/2013 11/20/2012Q0179 00093723633 1/31/2014 2/1/2013Q0179 00093723656 12/31/2999 12/31/2999Q0179 00093723693 1/31/2014 11/20/2012Q0179 00093730165 1/31/2013 6/17/2011Q0179 00143242230 12/31/2999 4/10/2012Q0179 00143242330 12/31/2999 4/10/2012Q0179 00173044600 12/31/2999 12/31/2999Q0179 00173044602 11/30/2013 8/29/2011Q0179 00173044604 12/31/2999 5/17/2011Q0179 00173044700 12/31/2999 12/31/2999Q0179 00173044702 7/31/2013 12/31/2999Q0179 00173044704 12/31/2999 12/31/2999Q0179 00173048900 12/31/2999 12/31/2999Q0179 00173056900 12/31/2999 12/31/2999Q0179 00173057000 12/31/2999 12/31/2999Q0179 00378031593 12/31/2999 12/31/2999Q0179 00378034493 12/31/2999 12/31/2999Q0179 00378773293 12/31/2999 12/31/2999Q0179 00378773493 12/31/2999 12/31/2999Q0179 00378773497 12/31/2999 12/31/2999Q0179 00490007500 12/31/2999 11/29/2012Q0179 00490007530 12/31/2999 11/29/2012Q0179 00490007560 12/31/2999 11/29/2012Q0179 00490007590 12/31/2999 11/29/2012Q0179 00781167931 12/31/2999 12/31/2999Q0179 00781167933 12/31/2999 12/31/2999Q0179 00781168131 12/31/2999 12/31/2999Q0179 00781168133 12/31/2999 12/31/2999Q0179 00781523806 12/31/2999 12/31/2999Q0179 00781523864 12/31/2999 12/31/2999Q0179 00781523906 12/31/2999 12/31/2999Q0179 00781523964 12/31/2999 12/31/2999Q0179 00781523980 12/31/2999 12/31/2999Q0179 00781525731 1/31/2013 12/1/2010Q0179 00781525831 2/28/2013 12/1/2010Q0179 16714067101 12/31/2020 12/31/2999

Page 247: *This document is a compilation of NDC:HCPCS combinations

Q0179 21695038030 12/31/2999 12/31/2999Q0179 21695047910 12/31/2999 12/31/2999Q0179 21695083404 12/31/2999 12/31/2999Q0179 21695083415 12/31/2999 12/31/2999Q0179 21695083430 12/31/2999 12/31/2999Q0179 21695083530 12/31/2999 12/31/2999Q0179 33358036902 12/31/2999 12/31/2999Q0179 33358037002 12/31/2999 12/31/2999Q0179 35356019730 12/31/2999 12/31/2999Q0179 35356044530 12/31/2999 12/31/2999Q0179 35356052430 12/31/2999 12/31/2999Q0179 43063005202 12/31/2999 12/31/2999Q0179 43063005204 12/31/2999 12/31/2999Q0179 49999078330 12/31/2999 12/31/2999Q0179 50111094543 12/31/2999 7/2/2008Q0179 50111094643 12/31/2999 7/2/2008Q0179 50111094669 12/31/2999 7/2/2008Q0179 51079052401 12/31/2999 12/31/2999Q0179 51079052420 12/31/2999 12/31/2999Q0179 51079052501 12/31/2999 12/31/2999Q0179 51079052520 12/31/2999 12/31/2999Q0179 51672409103 12/31/2999 12/31/2999Q0179 52152053830 3/31/2013 8/29/2011Q0179 52152053930 3/31/2013 8/29/2011Q0179 52959099103 12/31/2999 12/31/2999Q0179 54569487201 12/31/2999 4/30/2008Q0179 54569587300 12/31/2999 12/31/2999Q0179 54569616800 12/31/2999 12/31/2999Q0179 54868350800 12/31/2999 6/30/2011Q0179 54868350801 12/31/2999 6/30/2011Q0179 54868350802 12/31/2999 6/30/2011Q0179 54868350900 12/31/2999 6/30/2011Q0179 54868350901 12/31/2999 6/30/2011Q0179 54868350902 12/31/2999 6/30/2011Q0179 54868350903 12/31/2999 6/30/2011Q0179 54868508900 12/31/2999 6/30/2011Q0179 54868508901 12/31/2999 6/30/2011Q0179 54868508902 12/31/2999 6/30/2011Q0179 54868508903 12/31/2999 6/30/2011Q0179 54868508904 12/31/2999 6/30/2011Q0179 54868508905 12/31/2999 6/30/2011Q0179 54868573800 12/31/2999 12/31/2999Q0179 54868573801 12/31/2999 12/31/2999Q0179 54868574900 12/31/2999 12/31/2999Q0179 54868574901 12/31/2999 12/31/2999Q0179 54868580100 12/31/2999 12/31/2999Q0179 54868580101 12/31/2999 12/31/2999

Page 248: *This document is a compilation of NDC:HCPCS combinations

Q0179 55111015313 8/31/2013 12/31/2999Q0179 55111015330 12/31/2999 12/31/2999Q0179 55111015413 8/31/2013 12/31/2999Q0179 55111015430 12/31/2999 12/31/2999Q0179 55289055903 12/31/2999 12/31/2999Q0179 55289055905 12/31/2999 12/31/2999Q0179 55289055906 12/31/2999 12/31/2999Q0179 58016008400 12/31/2999 11/29/2012Q0179 58016008410 12/31/2999 11/29/2012Q0179 58016008430 12/31/2999 11/29/2012Q0179 58016008460 12/31/2999 11/29/2012Q0179 58016008490 12/31/2999 11/29/2012Q0179 58016082600 12/31/2999 7/12/2012Q0179 58016082630 12/31/2999 7/12/2012Q0179 58016082660 12/31/2999 7/12/2012Q0179 58016082690 12/31/2999 7/12/2012Q0179 59762299001 12/31/2999 12/31/2999Q0179 59762299002 12/31/2999 12/31/2999Q0179 59762299301 12/31/2999 12/31/2999Q0179 59762299302 12/31/2999 12/31/2999Q0179 60505038105 12/31/2999 12/31/2999Q0179 60505131103 12/31/2999 12/31/2999Q0179 60505131203 12/31/2999 12/31/2999Q0179 62756013001 12/31/2999 12/31/2999Q0179 62756013101 12/31/2999 12/31/2999Q0179 62756024064 12/31/2999 12/31/2999Q0179 62756035664 12/31/2999 12/31/2999Q0179 62756035666 12/31/2999 12/31/2999Q0179 63304045830 12/31/2999 12/31/2999Q0179 63304045930 12/31/2999 12/31/2999Q0179 65862018703 12/31/2999 12/31/2999Q0179 65862018705 12/31/2999 12/31/2999Q0179 65862018730 12/31/2999 12/31/2999Q0179 65862018803 12/31/2999 12/31/2999Q0179 65862018805 12/31/2999 12/31/2999Q0179 65862018830 12/31/2999 12/31/2999Q0179 67877016930 12/31/2999 12/31/2999Q0179 67877017030 12/31/2999 12/31/2999Q0179 68071069202 12/31/2999 12/31/2999Q0179 68094032559 12/31/2999 12/31/2999Q0179 68094032562 12/31/2999 12/31/2999Q0179 68115080230 12/31/2999 4/1/2009Q0179 68462010530 12/31/2999 12/31/2999Q0179 68462010630 12/31/2999 12/31/2999Q0179 68462015713 12/31/2999 12/31/2999Q0179 68462015811 12/31/2999 12/31/2999Q0179 68462015813 12/31/2999 12/31/2999

Page 249: *This document is a compilation of NDC:HCPCS combinations

Q0180 00088120205 12/31/2999 12/31/2999Q0180 00088120305 12/31/2999 12/31/2999Q0180 54868413800 12/31/2999 6/30/2010Q0180 54868413801 12/31/2999 6/30/2010Q0181 00054317644 12/31/2999 12/31/2999Q0181 00054417925 12/31/2999 12/31/2999Q0181 00054418025 12/31/2999 12/31/2999Q0181 00054418125 12/31/2999 12/31/2999Q0181 00054418225 12/31/2999 12/31/2999Q0181 00054418325 12/31/2999 12/31/2999Q0181 00054418425 12/31/2999 12/31/2999Q0181 00054817425 12/31/2999 12/31/2999Q0181 00054817525 12/31/2999 12/31/2999Q0181 00054817625 12/31/2999 12/31/2999Q0181 00054817925 12/31/2999 12/31/2999Q0181 00054818025 12/31/2999 12/31/2999Q0181 00054818125 12/31/2999 12/31/2999Q0181 00095008735 12/31/2999 12/31/2999Q0181 00095008851 12/31/2999 12/31/2999Q0181 44183050735 7/31/2013 6/28/2011Q0181 44183050851 7/31/2013 6/28/2011Q0181 49884008601 12/31/2999 12/31/2999Q0181 49999005906 12/31/2999 12/31/2999Q0181 52959039230 12/31/2999 12/31/2999Q0181 52959054710 12/31/2999 12/31/2999Q0181 52959054711 12/31/2999 12/31/2999Q0181 52959054712 12/31/2999 12/31/2999Q0181 52959054716 12/31/2999 12/31/2999Q0181 52959054720 12/31/2999 12/31/2999Q0181 52959054730 12/31/2999 12/31/2999Q0181 52959054750 12/31/2999 12/31/2999Q0181 54569032200 12/31/2999 12/31/2999Q0181 54569032203 12/31/2999 12/31/2999Q0181 54569032404 12/31/2999 12/31/2999Q0181 54569033601 12/31/2999 12/31/2999Q0181 54569572900 12/31/2999 12/31/2999Q0181 54868021800 12/31/2999 12/31/2999Q0181 54868021801 12/31/2999 12/31/2999Q0181 54868021803 12/31/2999 12/31/2999Q0181 54868021804 12/31/2999 12/31/2999Q0181 54868021805 12/31/2999 12/31/2999Q0181 54868021806 12/31/2999 12/31/2999Q0181 54868021807 12/31/2999 6/30/2012Q0181 54868091600 12/31/2999 6/30/2012Q0181 54868174400 12/31/2999 6/30/2012Q0181 54868533400 12/31/2999 12/31/2999Q0181 55289058228 12/31/2999 12/31/2999

Page 250: *This document is a compilation of NDC:HCPCS combinations

Q0181 58016029000 12/31/2999 11/29/2012Q0181 58016029002 12/31/2999 11/29/2012Q0181 58016029003 12/31/2999 11/29/2012Q0181 58016029012 12/31/2999 11/29/2012Q0181 58016029015 12/31/2999 11/29/2012Q0181 58016029020 12/31/2999 11/29/2012Q0181 58016029030 12/31/2999 11/29/2012Q0181 58016029073 12/31/2999 11/29/2012Q0181 58016029089 12/31/2999 11/29/2012Q0181 58016029300 12/31/2999 11/29/2012Q0181 58016029312 12/31/2999 11/29/2012Q0181 58016029315 12/31/2999 11/29/2012Q0181 58016029320 12/31/2999 11/29/2012Q0181 58016029330 12/31/2999 11/29/2012Q0181 58016078100 12/31/2999 11/29/2012Q0181 58016078110 12/31/2999 11/29/2012Q0181 58016078112 12/31/2999 11/29/2012Q0181 58016078114 12/31/2999 11/29/2012Q0181 58016078115 12/31/2999 11/29/2012Q0181 58016078120 12/31/2999 11/29/2012Q0181 58016078121 12/31/2999 11/29/2012Q0181 58016078124 12/31/2999 11/29/2012Q0181 58016078128 12/31/2999 11/29/2012Q0181 58016078130 12/31/2999 11/29/2012Q0181 58016078140 12/31/2999 11/29/2012Q0181 58016078150 12/31/2999 11/29/2012Q0181 60432046608 12/31/2999 12/31/2999Q0181 66267006612 12/31/2999 12/31/2999Q0181 66267006704 12/31/2999 12/31/2999Q0181 66267006710 12/31/2999 12/31/2999Q0181 66267006712 12/31/2999 12/31/2999Q0181 66267006720 12/31/2999 12/31/2999Q0181 66267006721 12/31/2999 12/31/2999Q2004 00327001105 12/31/2999 12/31/2999Q2009 00069600121 12/31/2999 12/31/2999Q2009 00069600125 12/31/2999 12/31/2999Q2009 00143978210 12/31/2999 12/31/2999Q2009 00143978825 12/31/2999 12/31/2999Q2009 00409485702 12/31/2999 12/31/2999Q2009 00409485710 12/31/2999 12/31/2999Q2009 00409485749 12/31/2999 12/31/2999Q2009 00409485750 12/31/2999 12/31/2999Q2009 00517690225 12/31/2999 12/31/2999Q2009 00641613625 12/31/2999 12/31/2999Q2009 00641613710 12/31/2999 12/31/2999Q2009 10139002511 12/31/2999 5/31/2009Q2009 10139002512 12/31/2999 6/30/2009

Page 251: *This document is a compilation of NDC:HCPCS combinations

Q2009 10139002521 12/31/2999 5/31/2009Q2009 10139002522 12/31/2999 6/30/2009Q2009 23360002102 12/31/2999 5/1/2011Q2009 23360002110 12/31/2999 5/1/2011Q2009 55390017510 12/31/2999 5/2/2011Q2009 55390017610 12/31/2999 5/2/2011Q2009 63323040302 12/31/2999 12/31/2999Q2009 63323040310 12/31/2999 12/31/2999Q2009 64679072901 12/31/2999 3/1/2009Q2009 64679073001 12/31/2999 3/1/2009Q2017 00015307519 12/31/2999 12/31/2999Q2040 00259160501 12/31/2999 12/31/2999Q2040 00259161001 12/31/2999 12/31/2999Q2041 67467018101 2/12/2013 12/31/2999Q2041 67467018102 9/15/2013 12/31/2999Q2043 30237890006 12/31/2999 12/31/2999Q2044 49401010101 12/31/2999 12/31/2999Q2044 49401010201 12/31/2999 12/31/2999Q2045 63833891501 12/31/2999 10/24/2011Q2046 61755000502 12/31/2999 12/31/2999Q2047 64764061010 12/31/2999 2/25/2013Q2047 64764062020 12/31/2999 2/25/2013Q2048 47335008250 12/31/2999 12/31/2999Q2048 59676096001 12/31/2999 12/31/2999Q2048 59676096002 12/31/2999 12/31/2999Q2049 47335008250 12/31/2999 12/31/2999Q2049 47335008350 12/31/2999 12/31/2999Q2050 17314960001 6/1/2012 4/4/2011Q2050 17314960002 6/1/2012 3/17/2011Q2050 47335004940 12/31/2999 12/31/2999Q2050 47335005040 12/31/2999 12/31/2999Q2050 59676096001 12/31/2999 12/31/2999Q2050 59676096002 12/31/2999 12/31/2999Q2051 00078038725 12/31/2999 12/31/2999Q2051 00078043561 12/31/2999 12/31/2999Q2051 00078059061 12/31/2999 12/31/2999Q2051 25021080166 12/31/2999 12/31/2999Q2051 42023015101 12/31/2999 12/31/2999Q2051 47335003540 12/31/2999 12/31/2999Q2051 47335096241 12/31/2999 12/31/2999Q2051 55111068507 12/31/2999 12/31/2999Q3025 59627000103 12/31/2999 12/31/2999Q3025 59627000104 12/31/2999 12/31/2999Q3025 59627000205 12/31/2999 12/31/2999Q3025 59627000207 12/31/2999 12/31/2999Q3025 59627000304 12/31/2999 12/31/2999Q3026 44087002203 12/31/2999 12/31/2999

Page 252: *This document is a compilation of NDC:HCPCS combinations

Q3026 44087004403 12/31/2999 12/31/2999Q3026 44087882201 12/31/2999 12/31/2999Q3027 59627000103 12/31/2999 12/31/2999Q3027 59627000205 12/31/2999 12/31/2999Q3027 59627000304 12/31/2999 12/31/2999Q4074 66215030200 12/31/2999 12/31/2999Q4074 66215030230 12/31/2999 12/31/2999Q4074 66215030300 12/31/2999 12/31/2999Q4074 66215030330 12/31/2999 12/31/2999Q4081 54569313700 12/31/2999 1/31/2003Q4081 54868252300 12/31/2999 5/11/2012Q4081 54868252301 12/31/2999 12/31/2999Q4081 54868567301 12/31/2999 5/11/2012Q4081 54868580200 12/31/2999 12/31/2999Q4081 55513012601 12/31/2999 12/31/2999Q4081 55513012610 12/31/2999 12/31/2999Q4081 55513014401 12/31/2999 12/31/2999Q4081 55513014410 12/31/2999 12/31/2999Q4081 55513014801 12/31/2999 12/31/2999Q4081 55513014810 12/31/2999 12/31/2999Q4081 55513026701 12/31/2999 12/31/2999Q4081 55513026710 12/31/2999 12/31/2999Q4081 55513028301 12/31/2999 12/31/2999Q4081 55513028310 12/31/2999 12/31/2999Q4081 55513047801 12/31/2999 12/31/2999Q4081 55513047810 12/31/2999 12/31/2999Q4081 59676030201 12/31/2999 12/31/2999Q4081 59676030202 12/31/2999 12/31/2999Q4081 59676030301 12/31/2999 12/31/2999Q4081 59676030302 12/31/2999 12/31/2999Q4081 59676030401 12/31/2999 12/31/2999Q4081 59676030402 12/31/2999 12/31/2999Q4081 59676031000 12/31/2999 12/31/2999Q4081 59676031001 12/31/2999 12/31/2999Q4081 59676031002 12/31/2999 12/31/2999Q4081 59676031204 12/31/2999 12/31/2999Q4081 59676032004 12/31/2999 12/31/2999Q4081 59676034001 12/31/2999 12/31/2999Q9954 00019112006 12/31/2999 12/31/2999Q9956 00407270703 12/31/2999 12/31/2999Q9957 11994001104 12/31/2999 12/31/2999Q9957 11994001116 12/31/2999 12/31/2999Q9958 00019086207 12/31/2999 12/31/2999Q9958 00019095211 12/31/2999 12/31/2999Q9958 00019095215 12/31/2999 10/1/2008Q9958 00270014955 12/31/2999 1/26/2001Q9958 00270014957 12/31/2999 12/31/2999

Page 253: *This document is a compilation of NDC:HCPCS combinations

Q9958 00270014960 12/31/2999 12/31/2999Q9958 00270080975 12/31/2999 2/27/2009Q9958 00270141030 12/31/2999 12/31/2999Q9960 00019318309 12/31/2999 12/31/2999Q9960 00019318315 12/31/2999 10/1/2008Q9961 00019095309 12/31/2999 12/31/2999Q9961 00019095311 12/31/2999 12/31/2999Q9961 00019095313 12/31/2999 12/31/2999Q9961 00019095315 12/31/2999 12/31/2999Q9961 00270026520 12/31/2999 12/31/2999Q9962 50419034405 12/31/2999 12/31/2999Q9962 50419034410 12/31/2999 12/31/2999Q9962 50419034412 12/31/2999 12/31/2999Q9962 50419034415 12/31/2999 12/31/2999Q9962 50419034421 12/31/2999 12/31/2999Q9962 50419034458 12/31/2999 12/31/2999Q9963 00019131707 12/31/2999 12/31/2999Q9963 00019131709 12/31/2999 12/31/2999Q9963 00019131715 12/31/2999 12/31/2999Q9963 00019481604 12/31/2999 12/31/2999Q9963 00019481605 12/31/2999 12/31/2999Q9963 00019481606 12/31/2999 12/31/2999Q9963 00270044535 12/31/2999 12/31/2999Q9963 00270044540 12/31/2999 12/31/2999Q9963 00270052330 12/31/2999 12/31/2999Q9965 00407140152 12/31/2999 12/31/2999Q9965 00407141110 12/31/2999 12/31/2999Q9965 00407141120 12/31/2999 12/31/2999Q9965 50419034005 12/31/2999 12/31/2999Q9966 00019132406 12/31/2999 1/2/2001Q9966 00019132411 12/31/2999 1/2/2001Q9966 00019132416 12/31/2999 1/2/2001Q9966 00019132421 12/31/2999 1/2/2001Q9966 00019132475 12/31/2999 1/2/2001Q9966 00019132481 12/31/2999 1/2/2001Q9966 00270131415 12/31/2999 12/31/2999Q9966 00270131430 12/31/2999 12/31/2999Q9966 00270131702 12/31/2999 12/31/2999Q9966 00270131705 12/31/2999 12/31/2999Q9966 00270131709 12/31/2999 12/31/2999Q9966 00270131741 12/31/2999 12/31/2999Q9966 00270141111 12/31/2999 12/31/2999Q9966 00270141125 12/31/2999 12/31/2999Q9966 00407141210 12/31/2999 12/31/2999Q9966 00407141220 12/31/2999 12/31/2999Q9966 00407141227 12/31/2999 12/31/2999Q9966 00407141228 6/3/2013 12/31/2999

Page 254: *This document is a compilation of NDC:HCPCS combinations

Q9966 00407141229 12/31/2999 12/31/2999Q9966 00407141230 12/31/2999 12/31/2999Q9966 00407141233 12/31/2999 12/31/2999Q9966 00407141234 12/31/2999 12/31/2999Q9966 00407141235 12/31/2999 12/31/2999Q9966 00407141238 12/31/2999 12/31/2999Q9966 00407141239 12/31/2999 9/27/2010Q9966 00407141240 3/31/2013 9/27/2010Q9966 00407141249 4/1/2013 1/2/2008Q9966 00407141250 12/31/2999 12/31/2999Q9966 00407141260 11/23/2014 1/11/2011Q9966 00407141284 2/3/2013 1/11/2011Q9966 00407222201 12/31/2999 12/31/2999Q9966 00407222202 12/31/2999 12/31/2999Q9966 00407222203 12/31/2999 12/31/2999Q9966 00407222216 12/31/2999 12/31/2999Q9966 00407222217 12/31/2999 12/31/2999Q9966 00407222219 12/31/2999 12/31/2999Q9966 00407222221 12/31/2999 12/31/2999Q9966 00407222223 12/31/2999 8/18/2009Q9966 50419034205 12/31/2999 12/31/2999Q9966 50419034210 12/31/2999 12/31/2999Q9966 50419034215 12/31/2999 12/31/2999Q9966 50419034220 12/31/2999 12/31/2999Q9966 50419034221 12/31/2999 12/31/2999Q9967 00019132300 12/31/2999 12/31/2999Q9967 00019132302 12/31/2999 12/31/2999Q9967 00019132304 12/31/2999 12/31/2999Q9967 00019132306 12/31/2999 12/31/2999Q9967 00019132311 12/31/2999 12/31/2999Q9967 00019132316 12/31/2999 12/31/2999Q9967 00019132321 12/31/2999 12/31/2999Q9967 00019132341 12/31/2999 12/31/2999Q9967 00019132352 12/31/2999 12/31/2999Q9967 00019132361 12/31/2999 12/31/2999Q9967 00019132373 12/31/2999 12/31/2999Q9967 00019132375 12/31/2999 12/31/2999Q9967 00019132377 12/31/2999 12/31/2999Q9967 00019132381 12/31/2999 12/31/2999Q9967 00019132383 12/31/2999 12/31/2999Q9967 00019132387 12/31/2999 1/2/2001Q9967 00019132390 12/31/2999 12/31/2999Q9967 00019132391 12/31/2999 12/31/2999Q9967 00019132395 12/31/2999 12/31/2999Q9967 00019133206 12/31/2999 12/31/2999Q9967 00019133211 12/31/2999 12/31/2999Q9967 00019133216 12/31/2999 12/31/2999

Page 255: *This document is a compilation of NDC:HCPCS combinations

Q9967 00019133221 12/31/2999 12/31/2999Q9967 00019133261 12/31/2999 12/31/2999Q9967 00019133275 12/31/2999 12/31/2999Q9967 00019133283 12/31/2999 1/2/2001Q9967 00019133306 12/31/2999 12/31/2999Q9967 00019133311 12/31/2999 12/31/2999Q9967 00019133316 12/31/2999 12/31/2999Q9967 00019133321 12/31/2999 12/31/2999Q9967 00019133341 12/31/2999 1/2/2001Q9967 00019133351 12/31/2999 12/31/2999Q9967 00019133361 12/31/2999 12/31/2999Q9967 00019133375 12/31/2999 12/31/2999Q9967 00019133377 12/31/2999 12/31/2999Q9967 00019133381 12/31/2999 12/31/2999Q9967 00019133383 12/31/2999 1/2/2001Q9967 00019133387 12/31/2999 12/31/2999Q9967 00019133390 12/31/2999 12/31/2999Q9967 00019133391 12/31/2999 12/31/2999Q9967 00019550506 12/31/2999 10/1/2008Q9967 00019550508 12/31/2999 10/1/2008Q9967 00019550521 12/31/2999 10/1/2008Q9967 00019550551 12/31/2999 10/1/2008Q9967 00270131525 12/31/2999 12/31/2999Q9967 00270131530 12/31/2999 12/31/2999Q9967 00270131535 12/31/2999 12/31/2999Q9967 00270131541 12/31/2999 12/31/2999Q9967 00270131547 12/31/2999 12/31/2999Q9967 00270131550 12/31/2999 12/31/2999Q9967 00270131559 12/31/2999 12/31/2008Q9967 00270131598 12/31/2999 12/31/2999Q9967 00270131601 12/31/2999 12/31/2999Q9967 00270131604 12/31/2999 12/31/2999Q9967 00270131630 12/31/2999 2/25/2009Q9967 00270131635 12/31/2999 12/31/2999Q9967 00270131637 12/31/2999 12/31/2999Q9967 00270131641 12/31/2999 12/31/2999Q9967 00270131652 12/31/2999 12/31/2999Q9967 00270131656 12/31/2999 12/31/2008Q9967 00270131657 12/31/2999 12/31/2008Q9967 00270131659 12/31/2999 12/31/2008Q9967 00270131698 12/31/2999 12/31/2999Q9967 00270141215 12/31/2999 12/31/2999Q9967 00407141310 12/31/2999 12/31/2999Q9967 00407141330 10/1/2013 12/31/2012Q9967 00407141341 12/31/2999 12/31/2012Q9967 00407141342 3/28/2015 12/31/2012Q9967 00407141343 12/31/2999 12/31/2012

Page 256: *This document is a compilation of NDC:HCPCS combinations

Q9967 00407141346 12/31/2999 12/31/2012Q9967 00407141350 4/12/2015 12/31/2012Q9967 00407141351 12/31/2999 12/31/2999Q9967 00407141353 12/31/2999 12/31/2012Q9967 00407141359 12/31/2999 12/31/2999Q9967 00407141360 12/31/2999 12/31/2999Q9967 00407141361 12/31/2999 12/31/2999Q9967 00407141362 12/31/2999 12/31/2999Q9967 00407141363 12/31/2999 12/31/2999Q9967 00407141365 12/31/2999 12/31/2999Q9967 00407141366 12/31/2999 12/31/2999Q9967 00407141368 12/31/2999 12/31/2999Q9967 00407141386 12/31/2999 12/31/2012Q9967 00407141387 12/31/2999 12/31/2012Q9967 00407141388 12/31/2999 12/31/2012Q9967 00407141389 12/31/2999 12/31/2012Q9967 00407141390 12/31/2999 12/31/2999Q9967 00407141391 12/31/2999 8/18/2009Q9967 00407141392 12/31/2999 12/31/2999Q9967 00407141393 4/29/2013 8/18/2009Q9967 00407141398 12/31/2999 12/31/2999Q9967 00407141403 12/31/2999 12/31/2999Q9967 00407141404 12/31/2999 9/24/2010Q9967 00407141441 12/31/2999 12/31/2012Q9967 00407141442 4/1/2013 9/24/2010Q9967 00407141444 12/31/2999 12/31/2012Q9967 00407141445 12/31/2999 12/31/2012Q9967 00407141450 3/29/2015 1/11/2011Q9967 00407141451 12/31/2999 12/31/2999Q9967 00407141460 12/31/2999 12/31/2999Q9967 00407141476 12/31/2999 12/31/2999Q9967 00407141482 12/31/2999 12/31/2012Q9967 00407141484 12/31/2999 12/31/2012Q9967 00407141485 12/31/2999 12/31/2012Q9967 00407141486 12/31/2999 12/31/2012Q9967 00407141487 12/31/2999 12/31/2012Q9967 00407141488 12/31/2999 12/31/2012Q9967 00407141489 12/31/2999 12/31/2999Q9967 00407141490 12/31/2999 12/31/2999Q9967 00407141491 12/31/2999 12/31/2999Q9967 00407141493 12/31/2999 12/31/2999Q9967 00407141494 12/31/2999 12/31/2999Q9967 00407141498 12/31/2999 12/31/2999Q9967 00407222301 12/31/2999 12/31/2999Q9967 00407222302 12/31/2999 12/31/2999Q9967 00407222303 12/31/2999 12/31/2999Q9967 00407222304 12/31/2999 12/31/2999

Page 257: *This document is a compilation of NDC:HCPCS combinations

Q9967 00407222306 12/31/2999 12/31/2999Q9967 00407222316 12/31/2999 12/31/2012Q9967 00407222317 12/31/2999 12/31/2999Q9967 00407222319 12/31/2999 12/31/2999Q9967 00407222321 12/31/2999 12/31/2999Q9967 00407222323 12/31/2999 12/31/2999Q9967 00407222360 12/31/2999 12/31/2999Q9967 00407222361 12/31/2999 12/31/2999Q9967 00407222362 12/31/2999 12/31/2012Q9967 00407222363 12/31/2999 12/31/2999Q9967 00407222364 12/31/2999 12/31/2999Q9967 00407222365 12/31/2999 12/31/2999Q9967 00407222366 12/31/2999 12/31/2999Q9967 00407222367 12/31/2999 12/31/2999Q9967 50419034405 12/31/2999 12/31/2999Q9967 50419034410 12/31/2999 12/31/2999Q9967 50419034412 12/31/2999 12/31/2999Q9967 50419034415 12/31/2999 12/31/2999Q9967 50419034421 12/31/2999 12/31/2999Q9967 50419034450 12/31/2999 12/31/2999Q9967 50419034458 12/31/2999 12/31/2999Q9967 50419034605 12/31/2999 12/31/2999Q9967 50419034610 12/31/2999 12/31/2999Q9967 50419034612 12/31/2999 12/31/2999Q9967 50419034615 12/31/2999 12/31/2999Q9967 50419034620 12/31/2999 12/31/2999Q9967 50419034625 12/31/2999 12/31/2999Q9967 50419034650 12/31/2999 12/31/2999Q9967 50419034658 12/31/2999 12/31/2999Q9967 67684100101 12/31/2999 12/31/2999Q9967 67684100102 12/31/2999 12/31/2999Q9967 67684100103 12/31/2999 12/31/2999Q9967 67684100104 12/31/2999 12/31/2999Q9968 00407141386 12/31/2999 12/31/2012S0023 00409744501 12/31/2999 12/31/2999S0030 00143977226 12/31/2999 5/13/2011S0030 00264553532 12/31/2999 12/31/2999S0030 00338105548 12/31/2999 12/31/2999S0030 00409781124 12/31/2999 12/31/2999S0030 00409781137 12/31/2999 12/31/2999S0030 36000000124 12/31/2999 12/31/2999S0073 00003223011 12/31/2999 12/31/2999S0073 00003224011 12/31/2999 12/31/2999S0077 00009072809 12/31/2999 12/31/2999S0077 00009077526 12/31/2999 12/31/2999S0077 00009087026 12/31/2999 12/31/2999S0077 00009090211 12/31/2999 12/31/2999

Page 258: *This document is a compilation of NDC:HCPCS combinations

S0077 00009090218 12/31/2999 12/31/2999S0077 00009312403 12/31/2999 12/31/2999S0077 00009337502 12/31/2999 12/31/2999S0077 00009338201 12/31/2999 12/31/2999S0077 00009338202 12/31/2999 12/31/2999S0077 00009344703 12/31/2999 12/31/2999S0077 00409405001 12/31/2999 12/31/2999S0077 00409405101 12/31/2999 12/31/2999S0077 00409405201 12/31/2999 12/31/2999S0077 00409405303 12/31/2999 12/31/2999S0077 00409405403 12/31/2999 12/31/2999S0077 00409405503 12/31/2999 12/31/2999S0077 00409419701 12/31/2999 12/31/2999S0077 54868369500 12/31/2999 6/30/2011S0077 54868415400 12/31/2999 6/30/2011S0077 54868416900 12/31/2999 6/30/2010S0077 63323028202 12/31/2999 12/31/2999S0077 63323028204 12/31/2999 12/31/2999S0077 63323028206 12/31/2999 12/31/2999S0077 63323028260 12/31/2999 12/31/2999S0164 00008092351 12/31/2999 12/31/2999S0164 00008092355 12/31/2999 12/31/2999S0166 00002759701 12/31/2999 12/31/2999S0171 00409141204 12/31/2999 12/31/2999S0171 00409141210 12/31/2999 12/31/2999S0171 00409141249 12/31/2999 12/31/2999S0171 00409141250 12/31/2999 12/31/2999S0171 10019050602 12/31/2999 12/31/2999S0171 10019050610 5/31/2013 4/3/2012S0171 10019050636 5/31/2013 4/3/2012S0171 10019050637 2/28/2013 4/3/2012S0171 10019050639 12/31/2999 12/31/2999S0171 10019050645 2/28/2013 4/3/2012S0171 55390050002 12/31/2999 12/31/2999S0171 55390050005 12/31/2999 12/31/2999S0171 55390050010 12/31/2999 12/31/2999S0176 00003083050 12/31/2999 12/31/2999S0176 54868136700 12/31/2999 6/30/2011S4993 00052026106 12/31/2999 12/31/2999S4993 00062141116 11/1/2013 3/15/2011S4993 00555900942 12/31/2999 12/31/2999S4993 00555901058 12/31/2999 12/31/2999S4993 00555901258 12/31/2999 12/31/2999S4993 00555901467 12/31/2999 12/31/2999S4993 00555902658 12/31/2999 12/31/2999S4993 00555904358 12/31/2999 12/31/2999S4993 00555904558 12/31/2999 12/31/2999

Page 259: *This document is a compilation of NDC:HCPCS combinations

S4993 00555904958 12/31/2999 12/31/2999S4993 00555906458 12/31/2999 12/31/2999S4993 00603760917 12/31/2999 12/31/2999S4993 21695085601 12/31/2999 12/31/2999S4993 21695085701 12/31/2999 12/31/2999S4993 35356001468 12/31/2999 5/17/2012S4993 35356036328 12/31/2999 12/31/2999S4993 35356036528 12/31/2999 12/31/2999S4993 35356037028 12/31/2999 12/31/2999S4993 50458019115 12/31/2999 12/31/2999S4993 50458025115 12/31/2999 12/31/2999S4993 51285008070 12/31/2999 12/31/2999S4993 51285008198 12/31/2999 12/31/2999S4993 52544025928 12/31/2999 12/31/2999S4993 52544027928 12/31/2999 12/31/2999S4993 52544055228 12/31/2999 12/31/2999S4993 52544063028 12/31/2999 12/31/2999S4993 52544084728 12/31/2999 12/31/2999S4993 52544093628 12/31/2999 12/31/2999S4993 52544094928 12/31/2999 12/31/2999S4993 52544095428 12/31/2999 12/31/2999S4993 52544096728 12/31/2999 12/31/2999S4993 54569067900 12/31/2999 8/2/2012S4993 54569068901 12/31/2999 12/31/2999S4993 54569499800 12/31/2999 12/31/2999S4993 54569499900 12/31/2999 12/31/2999S4993 54569579700 12/31/2999 12/31/2999S4993 54569579800 12/31/2999 12/31/2999S4993 54569603200 12/31/2999 12/31/2999S4993 54868042800 12/31/2999 6/30/2012S4993 54868044200 12/31/2999 5/10/2012S4993 54868044300 12/31/2999 4/30/2011S4993 54868050800 12/31/2999 5/10/2012S4993 54868050801 12/31/2999 6/30/2012S4993 54868151200 12/31/2999 6/30/2012S4993 54868270100 12/31/2999 4/30/2011S4993 54868386300 12/31/2999 6/30/2010S4993 54868404500 12/31/2999 12/31/2999S4993 54868474400 12/31/2999 12/31/2999S4993 54868475400 12/31/2999 12/31/2999S4993 54868477600 12/31/2999 12/31/2999S4993 54868485000 12/31/2999 12/31/2999S4993 54868485100 12/31/2999 12/31/2999S4993 54868528600 12/31/2999 12/31/2999S4993 54868532600 12/31/2999 12/31/2999S4993 54868535600 12/31/2999 12/31/2999S4993 55289024608 12/31/2999 2/3/2012

Page 260: *This document is a compilation of NDC:HCPCS combinations

S5000 00004110020 12/31/2999 12/31/2999S5000 00004110150 12/31/2999 12/31/2999S5000 00054413025 12/31/2999 12/31/2999J1080 00009052001 12/31/2999 12/31/2999J1080 00009052010 12/31/2999 12/31/2999J7307 00052433001 12/31/2999 12/31/2999J9250 00069014602 12/31/2999 1/1/2013J9250 00069014702 12/31/2999 1/1/2013J9250 00069014801 12/31/2999 1/1/2013J9250 00069014901 12/31/2999 12/31/2999J9250 00069018102 12/31/2999 1/1/2013J0456 00069040010 12/31/2999 12/31/2999J9000 00069400405 12/31/2999 12/31/2999J9000 00069401510 12/31/2999 12/31/2999J9000 00069402625 12/31/2999 12/31/2999J9000 00069403701 12/31/2999 12/31/2999J9000 00069449522 12/31/2999 12/31/2999J1650 00075802510 12/31/2999 12/31/2999J8999 00085136601 12/31/2999 12/31/2999J8999 00085136604 12/31/2999 12/31/2999J8999 00085141702 12/31/2999 12/31/2999J8999 00085142502 12/31/2999 12/31/2999J8999 00085142504 12/31/2999 12/31/2999J8999 00085143002 12/31/2999 12/31/2999J8999 00085151901 12/31/2999 12/31/2999J8999 00085151904 12/31/2999 12/31/2999J8999 00085300404 12/31/2999 12/31/2999J8520 00093747306 12/31/2999 12/31/2999J8521 00093747489 12/31/2999 12/31/2999J8999 00093759941 12/31/2999 12/31/2999J8999 00093760041 12/31/2999 12/31/2999J8999 00093760141 12/31/2999 12/31/2999J8999 00093760257 12/31/2999 12/31/2999J8999 00093763841 12/31/2999 12/31/2999J8999 00093763941 12/31/2999 12/31/2999J3490 00143967910 12/31/2999 12/31/2999J3490 00143968025 12/31/2999 12/31/2999J3490 00143968125 12/31/2999 12/31/2999J3490 00143968225 12/31/2999 12/31/2999C9134 00169701301 12/31/2999 12/31/2999J2543 00206210002 12/31/2999 12/31/2999J2543 00206310002 12/31/2999 12/31/2999J2543 00206410002 12/31/2999 12/31/2999S5000 00378326694 12/31/2999 12/31/2999J7518 00378420178 12/31/2999 12/31/2999J7518 00378420278 12/31/2999 12/31/2999J7644 00378797055 12/31/2999 12/31/2999

Page 261: *This document is a compilation of NDC:HCPCS combinations

J2270 00409113403 12/31/2999 12/31/2999J2270 00409113405 12/31/2999 12/31/2999J2270 00409113502 12/31/2999 12/31/2999J2270 00409189011 12/31/2999 12/31/2999J2270 00409189111 12/31/2999 12/31/2999J2270 00409202902 12/31/2999 12/31/2999J3490 00409226726 12/31/2999 12/31/2999J9999 00409226726 12/31/2999 12/31/2999Q9974 00409381412 12/31/2999 12/31/2999Q9974 00409381512 12/31/2999 12/31/2999J3430 00409915825 12/31/2999 12/31/2999J7508 00469087120 12/31/2999 12/31/2999J0151 00517360525 12/31/2999 12/31/2999J1953 00548563300 12/31/2999 12/31/2999Q9974 00641601910 12/31/2999 12/31/2999Q9974 00641602010 12/31/2999 12/31/2999Q9974 00641603901 12/31/2999 12/31/2999Q9974 00641604001 12/31/2999 12/31/2999J1270 00641615425 12/31/2999 12/31/2999J9260 00703367103 12/31/2999 12/31/2999J9260 00703367501 12/31/2999 12/31/2999J9260 00703367801 12/31/2999 12/31/2999J1270 00781330595 12/31/2999 12/31/2999J9025 00781925394 12/31/2999 12/31/2999J7682 10122082056 12/31/2999 12/31/2999J7335 10144092801 12/31/2999 12/31/2999J7335 10144092901 12/31/2999 12/31/2999J9190 16729027611 12/31/2999 12/31/2999J9190 16729027638 12/31/2999 12/31/2999J9190 16729027667 12/31/2999 12/31/2999J9190 16729027668 12/31/2999 12/31/2999J9250 16729027703 12/31/2999 12/31/2999J9260 16729027703 12/31/2999 12/31/2999J9250 16729027730 12/31/2999 12/31/2999J9260 16729027730 12/31/2999 12/31/2999J9250 16729027735 12/31/2999 12/31/2999C9399 17478012050 12/31/2999 12/31/2999J3490 17478012050 12/31/2999 12/31/2999J9260 17478012050 12/31/2999 12/31/2999C9399 17478012150 12/31/2999 12/31/2999J3490 17478012150 12/31/2999 12/31/2999C9399 17478012250 12/31/2999 12/31/2999J3490 17478012250 12/31/2999 12/31/2999J3590 17478012250 12/31/2999 12/31/2999J0770 23155019331 12/31/2999 12/31/2999J0278 23155029041 12/31/2999 12/31/2999J0278 23155029042 12/31/2999 12/31/2999

Page 262: *This document is a compilation of NDC:HCPCS combinations

J0780 23155029442 12/31/2999 12/31/2999J0697 24987035420 12/31/2999 12/31/2999J0697 24987035430 12/31/2999 12/31/2999J0697 24987043600 12/31/2999 12/31/2999J1956 25021013266 12/31/2999 12/31/2999J0151 25021030720 12/31/2999 12/31/2999J0151 25021030730 12/31/2999 12/31/2999J2354 25021045201 12/31/2999 12/31/2999J2354 25021045301 12/31/2999 12/31/2999J2354 25021045405 12/31/2999 12/31/2999J2354 25021045505 12/31/2999 12/31/2999J0640 25021081467 12/31/2999 12/31/2999C9399 36000003310 12/31/2999 12/31/2999J3490 36000003310 12/31/2999 12/31/2999J0735 39822200001 12/31/2999 12/31/2999J0735 39822201001 12/31/2999 12/31/2999J0894 43598034837 12/31/2999 12/31/2999J3490 43773100103 12/31/2999 12/31/2999S0189 43773100103 12/31/2999 12/31/2999J0295 44567021010 12/31/2999 12/31/2999J7518 51079050820 12/31/2999 12/31/2999J7518 51079050920 12/31/2999 12/31/2999J1631 53150048501 12/31/2999 12/31/2999J1000 54569258000 12/31/2999 1/31/2003C9399 55150016710 12/31/2999 12/31/2999J3490 55150016710 12/31/2999 12/31/2999C9399 55150016830 12/31/2999 12/31/2999J3490 55150016830 12/31/2999 12/31/2999C9399 55150016910 12/31/2999 12/31/2999J3490 55150016910 12/31/2999 12/31/2999C9399 55150017030 12/31/2999 12/31/2999J3490 55150017030 12/31/2999 12/31/2999C9399 55150017110 12/31/2999 12/31/2999J3490 55150017110 12/31/2999 12/31/2999C9399 55150017230 12/31/2999 12/31/2999J3490 55150017230 12/31/2999 12/31/2999J1640 55292070155 12/31/2999 12/31/2999J0221 58468016002 12/31/2999 12/31/2999J7520 59762100101 12/31/2999 12/31/2999J9370 61703030926 12/31/2999 12/31/2999J9250 61703040825 12/31/2999 12/31/2999J9260 61703040825 12/31/2999 12/31/2999J1740 62756021840 12/31/2999 12/31/2999J1580 63323001096 12/31/2999 12/31/2999C9399 63323013013 12/31/2999 12/31/2999J3490 63323013013 12/31/2999 12/31/2999J1580 63323017395 12/31/2999 12/31/2999

Page 263: *This document is a compilation of NDC:HCPCS combinations

J9206 63323019352 12/31/2999 12/31/2999J9206 63323019355 12/31/2999 12/31/2999C9399 63323026937 12/31/2999 12/31/2999J3490 63323026937 12/31/2999 12/31/2999C9399 63323026959 12/31/2999 12/31/2999J3490 63323026959 12/31/2999 12/31/2999C9399 63323026969 12/31/2999 12/31/2999J3490 63323026969 12/31/2999 12/31/2999C9399 63323026994 12/31/2999 12/31/2999J3490 63323026994 12/31/2999 12/31/2999J2795 63323028695 12/31/2999 12/31/2999J2795 63323028829 12/31/2999 12/31/2999J7608 63323069404 12/31/2999 12/31/2999J2310 67457029202 12/31/2999 12/31/2999J3370 67457033950 12/31/2999 12/31/2999J3370 67457034105 12/31/2999 12/31/2999J3370 67457034210 12/31/2999 12/31/2999J1100 67457042254 12/31/2999 12/31/2999J1100 67457042312 12/31/2999 12/31/2999J3260 67457042830 12/31/2999 12/31/2999J2430 67457043010 12/31/2999 12/31/2999C9399 67457043322 12/31/2999 12/31/2999J3490 67457043322 12/31/2999 12/31/2999J3590 67457043322 12/31/2999 12/31/2999J9999 67457043322 12/31/2999 12/31/2999J9000 67457043650 12/31/2999 12/31/2999C9399 67457044410 12/31/2999 12/31/2999J3490 67457044410 12/31/2999 12/31/2999J3590 67457044410 12/31/2999 12/31/2999J9999 67457044410 12/31/2999 12/31/2999J9100 67457045220 12/31/2999 12/31/2999J9250 67457048040 12/31/2999 12/31/2999J9260 67457048040 12/31/2999 12/31/2999Q0169 68001016100 12/31/2999 12/31/2999Q0169 68001016200 12/31/2999 12/31/2999Q0169 68001016208 12/31/2999 12/31/2999Q0169 68001016300 12/31/2999 12/31/2999C9022 68135010001 12/31/2999 12/31/2999J7613 76204020001 12/31/2999 12/31/2999J1455 76310002425 12/31/2999 12/31/2999C9025 00002766901 12/31/2999 12/31/2999C9025 00002767801 12/31/2999 12/31/2999J0129 00003218811 12/31/2999 12/31/2999J0129 00003218831 12/31/2999 12/31/2999C9399 00006302902 12/31/2999 12/31/2999J3490 00006302902 12/31/2999 12/31/2999J3590 00006302902 12/31/2999 12/31/2999

Page 264: *This document is a compilation of NDC:HCPCS combinations

J9999 00006302902 12/31/2999 12/31/2999J2920 00009003930 12/31/2999 12/31/2999J2930 00009004727 12/31/2999 12/31/2999C9399 00009030225 12/31/2999 12/31/2999J3490 00009030225 12/31/2999 12/31/2999J3590 00009030225 12/31/2999 12/31/2999C9399 00009060225 12/31/2999 12/31/2999J3490 00009060225 12/31/2999 12/31/2999J3590 00009060225 12/31/2999 12/31/2999C9399 00009090125 12/31/2999 12/31/2999J3490 00009090125 12/31/2999 12/31/2999J3590 00009090125 12/31/2999 12/31/2999J1815 00169643810 12/31/2999 12/31/2999J2543 00206550101 12/31/2999 12/31/2999J8520 00378251191 12/31/2999 12/31/2999J8521 00378251278 12/31/2999 12/31/2999J7613 00378827055 12/31/2999 12/31/2999J2310 00409121525 12/31/2999 12/31/2999J0151 00409193201 12/31/2999 12/31/2999J0151 00409193202 12/31/2999 12/31/2999C9399 00409226725 12/31/2999 12/31/2999J3490 00409226725 12/31/2999 12/31/2999J3590 00409226725 12/31/2999 12/31/2999C9399 00409226726 12/31/2999 12/31/2999J3590 00409226726 12/31/2999 12/31/2999J3430 00409915725 12/31/2999 12/31/2999Q9970 00517065001 12/31/2999 12/31/2999J2790 00562780500 12/31/2999 12/31/2999J1080 00574082710 12/31/2999 12/31/2999J7614 00591273623 12/31/2999 12/31/2999C9399 00781922009 12/31/2999 12/31/2999J3490 00781922009 12/31/2999 12/31/2999J3590 00781922009 12/31/2999 12/31/2999C9399 00781922109 12/31/2999 12/31/2999J3490 00781922109 12/31/2999 12/31/2999J3590 00781922109 12/31/2999 12/31/2999C9399 00781922209 12/31/2999 12/31/2999J3490 00781922209 12/31/2999 12/31/2999J3590 00781922209 12/31/2999 12/31/2999J9999 00781922209 12/31/2999 12/31/2999J0256 00944281401 12/31/2999 12/31/2999J7192 00944304510 12/31/2999 12/31/2999J7192 00944304610 12/31/2999 12/31/2999J7192 00944304710 12/31/2999 12/31/2999J7192 00944305102 12/31/2999 12/31/2999J7192 00944305202 12/31/2999 12/31/2999J7192 00944305302 12/31/2999 12/31/2999

Page 265: *This document is a compilation of NDC:HCPCS combinations

J7192 00944305402 12/31/2999 12/31/2999J2788 13533066106 12/31/2999 12/31/2999J2765 23155024041 12/31/2999 12/31/2999J2405 23155037841 12/31/2999 12/31/2999J2405 23155037842 12/31/2999 12/31/2999J0150 25021030168 12/31/2999 12/31/2999J0171 42023016801 12/31/2999 12/31/2999J0894 47335036141 12/31/2999 12/31/2999C9399 47335050844 12/31/2999 12/31/2999J3590 47335050844 12/31/2999 12/31/2999J9999 47335050844 12/31/2999 12/31/2999C9399 47335050944 12/31/2999 12/31/2999J3590 47335050944 12/31/2999 12/31/2999J9999 47335050944 12/31/2999 12/31/2999C9399 50242007001 12/31/2999 12/31/2999J3590 50242007001 12/31/2999 12/31/2999J9999 50242007001 12/31/2999 12/31/2999A9585 50419032537 12/31/2999 12/31/2999J7302 50419042301 12/31/2999 12/31/2999S4993 50458019416 12/31/2999 12/31/2999S4993 50458019715 12/31/2999 12/31/2999J3490 51552068203 12/31/2999 12/31/2999J3095 52118000201 12/31/2999 12/31/2999S4993 52544024728 12/31/2999 12/31/2999S4993 52544063128 12/31/2999 9/10/2014S4993 54868473000 12/31/2999 12/31/2999J1442 55513020991 12/31/2999 12/31/2999J1442 55513054601 12/31/2999 12/31/2999J1442 55513092491 12/31/2999 12/31/2999C9399 62627010025 12/31/2999 12/31/2999J3490 62627010025 12/31/2999 12/31/2999J3590 62627010025 12/31/2999 12/31/2999J9999 62627010025 12/31/2999 12/31/2999C9399 62627010050 12/31/2999 12/31/2999J3490 62627010050 12/31/2999 12/31/2999J3590 62627010050 12/31/2999 12/31/2999J9999 62627010050 12/31/2999 12/31/2999J3411 63323001309 12/31/2999 12/31/2999J2150 63323002429 12/31/2999 12/31/2999J2720 63323022994 12/31/2999 12/31/2999J2720 63323022995 12/31/2999 12/31/2999J1570 63323031594 12/31/2999 12/31/2999J0133 63323032514 12/31/2999 12/31/2999J0133 63323032524 12/31/2999 12/31/2999S0073 63323040120 12/31/2999 12/31/2999S0073 63323040220 12/31/2999 12/31/2999J7030 63323062310 12/31/2999 12/31/2999

Page 266: *This document is a compilation of NDC:HCPCS combinations

J7040 63323062310 12/31/2999 12/31/2999J7050 63323062310 12/31/2999 12/31/2999J7030 63323062351 12/31/2999 12/31/2999J7040 63323062351 12/31/2999 12/31/2999J7050 63323062351 12/31/2999 12/31/2999J7030 63323062359 12/31/2999 12/31/2999J7040 63323062359 12/31/2999 12/31/2999J7050 63323062359 12/31/2999 12/31/2999C9132 63833038702 12/31/2999 12/31/2999J7180 63833051802 12/31/2999 12/31/2999J1557 64208823404 12/31/2999 12/31/2999J7517 64380072506 12/31/2999 12/31/2999J7517 64380072507 12/31/2999 12/31/2999J7517 64380072606 12/31/2999 12/31/2999J7517 64380072607 12/31/2999 12/31/2999C9135 64406091101 12/31/2999 12/31/2999C9135 64406092201 12/31/2999 12/31/2999C9135 64406093301 12/31/2999 12/31/2999C9135 64406094401 12/31/2999 12/31/2999C9026 64764030020 12/31/2999 12/31/2999J1100 67457042130 12/31/2999 12/31/2999J1630 67457042612 12/31/2999 12/31/2999C9399 67457043710 12/31/2999 12/31/2999J3490 67457043710 12/31/2999 12/31/2999J3590 67457043710 12/31/2999 12/31/2999J9999 67457043710 12/31/2999 12/31/2999C9399 67457044753 12/31/2999 12/31/2999J3490 67457044753 12/31/2999 12/31/2999J3590 67457044753 12/31/2999 12/31/2999J9999 67457044753 12/31/2999 12/31/2999C9023 67979051143 12/31/2999 12/31/2999Q0162 68001024617 12/31/2999 12/31/2999Q0162 68001024701 12/31/2999 12/31/2999Q0162 68001024717 12/31/2999 12/31/2999J2270 76045000410 12/31/2999 12/31/2999J2270 76045000510 12/31/2999 12/31/2999J2270 76045000610 12/31/2999 12/31/2999J2270 76045000710 12/31/2999 12/31/2999J2270 76045000810 12/31/2999 12/31/2999