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  4. 10% PREMASOL - sulfite-free (Amino Acid) Injection 1000 mL in VIAFLEX Plastic Container. Pharmacy Bulk Package
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10% PREMASOL - sulfite-free (Amino Acid) Injection 1000 mL in VIAFLEX Plastic Container. Pharmacy Bulk Package
Item Number: 2B0009
GTIN:  0303381130046
GTIN-CS:  50303381130041
10% PREMASOL - sulfite-free (Amino Acid) Injection 1000 mL in VIAFLEX Plastic Container. Pharmacy Bulk Package. Not for Direct Infusion. NDC 0338-1130-04
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Specifications

Product Characteristics

Minimum Storage Temperature 2.0 °C
Maximum Storage Temperature 25.0 °C
Volume 1000.0 ml
DEHP Free No
PVC Free No
Latex Free No
Acetate 94 mg/L
Amino Acid Concentration 10%
Amino Acid 10 g/100 mL
Chloride 3 mg/L
Container Type VIAFLEX
Containes Preservative No
Nitrogen 1.55 g/100 mL
Osmolarity Molperl 865
pH 5.5
Rx Only Yes
Specific Gravity 1.03
Storage Recommendations Stored at room temperature (25°C/77°F). Brief exposure up to 40°C/104°F does not adversely affect the product. Avoid excessive heat. Protect from freezing.

Carton

Units per Case 12.0
Carton Weight 32.0 lb.
Carton Length 14.4 in.
Carton Width 13.1 in.
Carton Height 9.8 in.
Carton Volume 1.07 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
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
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
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 2B0009
Sales Unit case
GTIN 0303381130046
GTIN-CS 50303381130041
National Drug Code 00338113004
Documents

Documentation

Manual

Package Insert Link