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  3. 10% TRAVASOL (Amino Acid) Injection 500 mL in VIAFLEX Plastic Container. Pharmacy Bulk Package
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10% TRAVASOL (Amino Acid) Injection 500 mL in VIAFLEX Plastic Container. Pharmacy Bulk Package
Item Number: 1B6623
GTIN:  0303380644032
GTIN-CS:  50303380644037
10% TRAVASOL (Amino Acid) Injection 500 mL in VIAFLEX Plastic Container. Pharmacy Bulk Package. Not for Direct Infusion.
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Specifications

Product Characteristics

Minimum Storage Temperature 15.0 °C
Maximum Storage Temperature 25.0 °C
Volume 500.0 ml
DEHP Free Yes
PVC Free Yes
Latex Free No
Shelf Life from Manufacture 0
Acetate 88 mg/L
Amino Acid Concentration 10%
Amino Acid 10 g/100 mL
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
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"
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"
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"
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"
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 0303380644032
GTIN-CS 50303380644037
National Drug Code 00338064403