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Nitroglycerin in 5% Dextrose Injection 25 mg/250 mL (100 mcg/mL) in Glass Container

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SKU: 1A0692

Nitroglycerin in 5% Dextrose Injection 25 mg/ 250 mL (100 mcg/mL). Liquid Premix Medication in Glass Container. NDC 0338-1047-02

Product information last updated May-04-2020

Product Characteristics

Trademark: Baxter is a trademark of Baxter International Inc., its subsidiaries or affiliates.
Container Type: Glass
Volume: 250 ML
Drug Class: Vasodilator
Dosage Form: Liquid
Diluent: Dextrose
Strength: 25 mg/250 mL
Concentration: 100 mcg/mL
Shelf Life from manufacture: 18 months
Contains Preservative: No
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.
Rx Only: Yes

Carton

Length: 11.3 IN
Width: 8.6 IN
Height: 7.2 IN
Volume: 0.41 FC
Weight: 12 LB
Pack Factor: 12

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.