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5% Dextrose and 0.2% Sodium Chloride Injection, USP, 250 mL VIAFLEX Plastic Container

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SKU: 2B1092Q

5% Dextrose and 0.2% Sodium Chloride Injection, USP, 250 mL VIAFLEX Plastic Container. NDC: 0338-0077-02

Product information last updated Aug-26-2020

Product Characteristics

Latex: Not Made with Natural Rubber Latex
Container Type: VIAFLEX
Volume: 250 ML
Dextrose Concentration: 5%
Total Calories: 170 Kcal/L
Sodium Concentration: 0.2%
Sodium: 34 mEq/L
Chloride: 34 mEq/L
Osmolarity (mOsmol/L): 321
Specific Gravity: 1.02
pH: 4
Fill Range Volume (mL): 265 - 285
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.
Packaging: Single Pack
Rx Only: Yes

Carton

Length: 15.5 IN
Width: 12 IN
Height: 10 IN
Volume: 1.08 FC
Weight: 26 LB
Pack Factor: 36

Reimbursement Information

HCPCS Code HCPCS Descriptor
J7042 5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT)
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.