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  3. 3-Port Manifold with Check Valves, 4-Way Stopcock Extension Set, 2 INTERLINK Injection Sites, 41" (103 cm)
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3-Port Manifold with Check Valves, 4-Way Stopcock Extension Set, 2 INTERLINK Injection Sites, 41" (103 cm)
Item Number: 2C6921
GTIN:  0085412035451
GTIN-CS:  50085412035456
3-Port Manifold with Check Valves, Approximate Volume 1.4 mL, Large Bore 4-Way Stopcock Extension Set with Rotating Male Luer Lock, 2 INTERLINK Injection Sites, Male Luer Lock Adapter with Retractable Collar. Approximate Volume 6.1 mL. Approximate length 41" (103 cm). Contains DEHP. Sterile package, nonpyrogenic.
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Specifications

Product Characteristics

Minimum Storage Temperature 0.0 °C
Maximum Storage Temperature 0.0 °C
Length 41.0 in.
Sterilisation Method RADIATION - GAMMA
DEHP Free Yes
PVC Free Yes
Latex Free No
Priming Volume 1.4 + 6.1 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 Interlink

Carton

Units per Case 48.0
Carton Weight 9.9 lb.
Carton Length 24.7 in.
Carton Width 14.0 in.
Carton Height 9.6 in.
Carton Volume 3319.68 ci

Reimbursement Information

HCPCS Code HCPCS Description
A4223 Infusion supplies not used with external infusion pump, per cassette or bag (list drugs seperately)
A4222 Infusion supplies for external drug infusion pumps per cassette or bag (list drugs seperately)
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 2C6921
Sales Unit case
GTIN 0085412035451
GTIN-CS 50085412035456