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BREVIBLOC Injection (Esmolol Hydrochloride) 2,500 mg/250 mL in INTRAVIA Plastic Container

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SKU: 1001905561

BREVIBLOC Premixed Injection (Esmolol Hydrochloride) 2,500 mg/250 mL (10 mg/mL) Ready-to-use-Bags in INTRAVIA Plastic Container. Liquid Premix. NDC 10019-0055-61

Product information last updated Mar-18-2020

Product Characteristics

Trademark: BREVIBLOC - Trademark of Baxter International Inc., its subsidiaries or affiliates.
Container Type: INTRAVIA
Volume: 250 ML
Drug Class: Anti-Arrythmics
Dosage Form: Liquid
Strength: 2500 mg/250 mL
Concentration: 10 mg/mL
Shelf Life from manufacture: 24 months
Contains Preservative: No
Storage Recommendations: Store at 25°C (77°F). Excursions permitted to 15°-30°C (59°-86°F) [see USP Controlled Room Temperature]. Protect from freezing. Avoid excessive heat.
Rx Only: Yes
Package Insert Link: baxterpi.com/pi-pdf/Brevi(..)

Carton

Length: 13.38 IN
Width: 13.38 IN
Height: 5.5 IN
Volume: 0.57 FC
Weight: 8 LB
Pack Factor: 10

Reimbursement Information

HCPCS Code HCPCS Descriptor
J3490 UNCLASSIFIED DRUGS
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.