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  4. Nitroglycerin in 5% Dextrose Injection 50 mg/250 mL (200 mcg/mL) in Glass Container
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Nitroglycerin in 5% Dextrose Injection 50 mg/250 mL (200 mcg/mL) in Glass Container
Item Number: 1A0694
GTIN:  0303381049027
GTIN-CS:  50303381049022
Nitroglycerin in 5% Dextrose Injection 50 mg/ 250 mL (200 mcg/mL). Liquid Premix Medication in Glass Container. NDC 0338-1049-02
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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 200 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 50 mg/250 mL

Carton

Units per Case 12.0
Carton Weight 12.0 lb.
Carton Length 11.3 in.
Carton Width 8.5 in.
Carton Height 7.3 in.
Carton Volume 0.41 fc

Reimbursement Information

HCPCS Code HCPCS Description
A4216 STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML
J2305 Inj, nitroglycerin, 5 mg
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 1A0694
Sales Unit case
GTIN 0303381049027
GTIN-CS 50303381049022
National Drug Code 00338104902