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  3. 3-Port Manifold with Check Valves, 4-Way Stopcock Extension Set, 2 CLEARLINK Luer Activated Valves, 40" (101 cm)
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3-Port Manifold with Check Valves, 4-Way Stopcock Extension Set, 2 CLEARLINK Luer Activated Valves, 40" (101 cm)
Item Number: 2C8921
GTIN:  0085412071718
GTIN-CS:  50085412071713
3-Port Manifold with Check Valves, Approximate Volume 1.4 mL, Large Bore 4-way Stopcock Extension Set with Rotating Male Luer Lock, 2 CLEARLINK Luer Activated Valves, Male Luer Lock Adapter with Retractable Collar. Approximate Volume 6.2 mL. Approximate Length 40" (101 cm). Contains DEHP. Sterile Package, nonpyrogenic.
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Specifications

Product Characteristics

Minimum Storage Temperature -99.0 °C
Maximum Storage Temperature 99.0 °C
Length 40.0 in.
Sterilisation Method RADIATION - GAMMA
DEHP Free Yes
PVC Free Yes
Latex Free No
Priming Volume 1.4 + 6.2 Cubic Foot
Shelf Life from Manufacture 730
Backcheck Valve No
Collar Type Retractable
Control-A-Flo No
Manifold 3-port
Number Of Ysites 2
Rx Only Yes
Sterility Sterile Package
Stopcock 1
Tubing Configuration STRAIGHT
T-Connector None
Type Of Injection Site Clearlink

Carton

Units per Case 48.0
Carton Weight 5.45 lb.
Carton Length 17.2 in.
Carton Width 12.7 in.
Carton Height 10.5 in.
Carton Volume 1.33 fc

Reimbursement Information

HCPCS Code HCPCS Description
A4222 INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)
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 2C8921
Sales Unit case
GTIN 0085412071718
GTIN-CS 50085412071713