|Generic Name(S)||Strength||Dosage Form||ICD Code|
|Ethacrynic Acid||25mg, 50mg||Tablets, Injection||Y52|
|Nesiritide||1.5mg, single-use Vials||Injection||Y52|
|Prep kit for Technetium Tc99 Sestamibi||5mL Vial||Injection||Y52|
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