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  3. 10% TRAVASOL (AMINO ACID) INJ.
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10% TRAVASOL (AMINO ACID) INJ.
Item Number: 1B6623
GTIN:  00303380644032
GTIN-CS:  50303380644037
10% TRAVASOL (AMINO ACID) INJ.
Specifications

Product Characteristics

Volume 500.0 ml
Dehp Free No
Pvc Free No
Latex Free Yes
Shelf Life from Manufacture 24 Months
Acetate 88 mg/L
Amino Acid Concentration g/100 mL
Amino Acid 10% 
Backcheck Valve No
Chloride 40 mg/L
Container Type VIAFLEX
Containes Preservative No
Nitrogen 1.65 g/100 mL
Osmolarity Molperl 998
Ph 6
Rx Only Yes
Specific Gravity 1.03
Storage Recommendations Stored at room temperature (25°C/77°F). Avoid excessive heat. Protect from freezing.

Carton

Units per Case 24.0
Carton Weight 30.2 lb.
Carton Length 15.16 in.
Carton Width 11.22 in.
Carton Height 12.2 in.
Carton Volume 1.2 fc

Reimbursement Information

HCPCS Code HCPCS Description
B4189 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 10 TO 51 GRAMS OF PROTEIN - PREMIX
B4199 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, OVER 100 GRAMS OF PROTEIN - PREMIX
B4193 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 52 TO 73 GRAMS OF PROTEIN - PREMIX
B4197 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 74 TO 100 GRAMS OF PROTEIN - PREMIX
Medication Delivery Reimbursement Hotline 888-338-0001

Information Source : CMS

Disclaimer:The coverage, coding, and payment information included in this guide has been compiled from various resources for informational use as a tool to assist providers with reimbursement issues. This information is current as of 3/31/2008; however this information is subject to change and should not be construed as legal advice. Providers should exercise independent clinical judgment when selecting codes and submitting claims to accurately reflect services rendered to individual patients. Baxter Healthcare Corporation does not guarantee success in obtaining insurance payments. Providers are encouraged to contact third-party payors for specific information on their coverage, coding, and payment policies.
Ordering Information
Item Number 1B6623
Sales Unit case
GTIN 00303380644032
GTIN-CS 50303380644037
National Drug Code 0338064403