Valley Medical Pharmacy 
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eRx ID#0585957 
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Automix Empty Viaflex Container Bags 24X1 Each By Baxter IV Systems

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Automix Empty Viaflex Container Bags 24X1 Each By Baxter IV Systems

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UPC No.: 854120001337 Mfg.Part No.:2B8086
Automix Empty Viaflex Container Bags 24X1 Each By Baxter IV Systems RXB10043891 NDC NDC: 85412-0001-33
Item No.: RXD2975241
Ndc 85412000133
Generic Name Iv Equipment
Trade Name Automix Viaflex ContainerAdditional Description 2000Ml
Form Bags
Size 24X1Ea
Unit Of Measure Ea
Unit Of Sale Cs
Schedule No. 0
Private Label 999
Multi-Source N
Active Status Active
Generic Ind. Non Drug
Drug Class Rx
Vendor Name

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Empty VIAFLEX Container. For use with AUTOMIX Compounder, 2000 mL


Product Characteristics
Sterilization method: Ethylene Oxide Gas


Reimbursement Information
HCPCS Code HCPCS Descriptor
A4222 INFUSION SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)
A4223 INFUSION SUPPLIES NOT USED WITH EXTERNAL INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)
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.
A120831