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  4. Nitroglycerin in 5% Dextrose Injection 25 mg/250 mL (100 mcg/mL) in Glass Container
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Nitroglycerin in 5% Dextrose Injection 25 mg/250 mL (100 mcg/mL) in Glass Container
Item Number: 1A0692
GTIN:  0303381047023
GTIN-CS:  50303381047028
Nitroglycerin in 5% Dextrose Injection 25 mg/ 250 mL (100 mcg/mL). Liquid Premix Medication in Glass Container. NDC 0338-1047-02
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Specifications

Product Characteristics

Minimum Storage Temperature 0.0 °C
Maximum Storage Temperature 0.0 °C
Volume 250.0 cf
DEHP Free No
PVC Free No
Latex Free No
Shelf Life from Manufacture 0
Concentration 100 mcg/mL
Container Type Glass
Containes Preservative No
Diluent Dextrose
Dosage Form Liquid
Drug Class Vasodilator
Rx Only Yes
Storage Recommendations Store the product at room temperature 25°C (77°F). Brief exposure up to 40°C does not adversely affect the product. Protect from light until time of use.
Strength 25 mg/250 mL

Carton

Units per Case 12.0
Carton Weight 12.0 lb.
Carton Length 11.3 in.
Carton Width 8.6 in.
Carton Height 7.2 in.
Carton Volume 0.4 fc

Reimbursement Information

HCPCS Code HCPCS Description
J2305 Inj, nitroglycerin, 5 mg
A4216 STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML
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 1A0692
Sales Unit case
GTIN 0303381047023
GTIN-CS 50303381047028
National Drug Code 00338104702