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| Generic Name(s) | Strength | Dosage Form | ICD Code |
| Butabarbital | 30mg, 50mg | Tablets | Y47.0 |
| Dexmedetomidine | 200 mcg/2 mL | Injection | Y47.8 |
| Eszopiclone | 1 mg, 2 mg, 3 mg | Tablets | Y47.8 |
| Fospropofol | 35 mg/mL | Injection | Y47.9 |
| Midazolam | 5mg midazolam/mL | Injection | Y47.1 |
| Nitrazepam | 5mg, 10mg | Tablets | Y47.1 |
| Pentobarbital | 50-mL multiple-dose Vial | Injection | Y47.0 |
| Ramelteon | 8mg | Tablets | Y47.8 |
| Secobarbital | 100mg | Capsules | Y47.0 |
| Zopiclone | 3.75mg, 7.5mg | Tablets | Y47.8 |
