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Lidocaine Hydrochloride in 5% Dextrose Injection, USP, 2 grams/500 mL (4 mg/mL) in VIAFLEX Plastic Container. Liquid Premix.

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SKU: 2B0973

Lidocaine Hydrochloride in 5% Dextrose Injection, USP, 2 grams/500 mL (4 mg/mL) in VIAFLEX Plastic Container. Liquid Premix. NDC 0338-0409-03

Product information last updated May-04-2020

Product Characteristics

Container Type: VIAFLEX
Volume: 500 ML
Drug Class: Anti-Arrythmics
Dosage Form: Liquid
Diluent: Dextrose
Strength: 2 gm/500 mL
Concentration: 4 mg/mL
Shelf Life from manufacture: 18 months
Contains Preservative: No
Storage Recommendations: Store at room temperature 25°C (77°F); brief exposure up to 40° C (104° F) does not adversely affect the product.
Rx Only: Yes

Carton

Length: 15.75 IN
Width: 10 IN
Height: 10.5 IN
Volume: 0.96 FC
Weight: 26 LB
Pack Factor: 18

Reimbursement Information

HCPCS Code HCPCS Descriptor
J2001 INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 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.