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  3. CLINIMIX E 4.25/5 sulfite-free (4.25% Amino Acid with Electrolytes in 5% Dextrose with Calcium) Injection, 2000 mL in CLARITY Dual Chamber Container
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CLINIMIX E 4.25/5 sulfite-free (4.25% Amino Acid with Electrolytes in 5% Dextrose with Calcium) Injection, 2000 mL in CLARITY Dual Chamber Container
Item Number: 2B7716
GTIN:  00303381113049
GTIN-CS:  50303381113044
CLINIMIX E 4.25/5 sulfite-free (4.25% Amino Acid with Electrolytes in 5% Dextrose with Calcium) Injection 2000 mL in CLARITY Dual Chamber Container. NDC 0338-1113-04
Specifications

Product Characteristics

Volume 2000.0 ml
Latex Free Yes
Acetate MG_L 
Amino Acid Concentration Kcal/L
Amino Acid 4.25% 
Backcheck Valve No
Calcium 4.5 mg/L
Chloride 39 mg/L
Container Type CLARITY
Containes Preservative No
Dextrose Concentration 5%
Dextrose 170 Kcal/L
Free Water Content 1881
Magnesium 5 mg/L
Nitrogen 7.02 g/L
Osmolarity Molperl 815
Phosphate 15 mEq/L
Polyethlene Lined No
Potassium 30 mg/L
Protein 42.5 G_L
Rx Only Yes
Sodium 35 mg/L
Specific Gravity 1.04
Storage Recommendations Store at room temperature (25°C/77°F) (may briefly store at up to 40°C/104°F). Refrigerated storage is limited to 9 days once the protective foil overwrap has been opened. Protect from freezing.
Total Calories 340 Kcal/L

Carton

Units per Case 4.0
Carton Weight 19.8 lb.
Carton Length 20.2 in.
Carton Width 9.8 in.
Carton Height 8.7 in.
Carton Volume 1.0 fc

Reimbursement Information

HCPCS Code HCPCS Description
B4197 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 74 TO 100 GRAMS OF PROTEIN - PREMIX
B4193 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 52 TO 73 GRAMS OF PROTEIN - PREMIX
B4189 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 10 TO 51 GRAMS OF PROTEIN - PREMIX
B4199 PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, OVER 100 GRAMS OF PROTEIN - PREMIX
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 2B7716
Sales Unit case
GTIN 00303381113049
GTIN-CS 50303381113044
National Drug Code 0338111304

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