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  4. BREVIBLOC Injection (Esmolol Hydrochloride) 2,500 mg/250 mL in INTRAVIA Plastic Container
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BREVIBLOC Injection (Esmolol Hydrochloride) 2,500 mg/250 mL in INTRAVIA Plastic Container
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Item Number: 1001905561
GTIN:  00310019055619
GTIN-CS:  50310019055614
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
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Specifications

Product Characteristics

Trademark BREVIBLOC - Trademark of Baxter International Inc., its subsidiaries or affiliates.
Volume 250.0 ml
Latex Free Yes
Shelf Life from Manufacture 24 Months
Concentration 10 mg/mL
Container Type INTRAVIA
Containes Preservative No
Dosage Form Liquid
Drug Class Anti-Arrythmics
Polyethlene Lined No
Rx Only Yes
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.
Strength 2500 mg/250 mL

Carton

Units per Case 10.0
Carton Weight 8.0 lb.
Carton Length 13.38 in.
Carton Width 13.38 in.
Carton Height 5.5 in.
Carton Volume 0.57 fc

Reimbursement Information

HCPCS Code HCPCS Description
J1805 Inj, esmolol hcl, 10mg
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.
Ordering Information
Item Number 1001905561
Sales Unit pack
GTIN 00310019055619
GTIN-CS 50310019055614
National Drug Code 1001905561
Documents

Documentation

PDF

Package Insert Link

     203052r1