Potassium Chloride In Dextrose And Sodium Chloride Injection, Solution
NDC Package 0990-7902-03

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Potassium Chloride In Dextrose And Sodium Chloride (dextrose monohydrate, sodium chloride, and potassium chloride) injection is these solutions are indicated in patients requiring parenteral administration of potassium chloride with minimal carbohydrate calories and sodium chloride. This formulation utilizes a injection, solution delivery system. Marketed by Icu Medical Inc., this product is identified by NDC 0990-7902 and is authorized under FDA application NDA018362.

Identification & Billing

NDC Package Code
0990-7902-03
Package Description
24 POUCH in 1 CASE / 1 BAG in 1 POUCH / 500 mL in 1 BAG
Product Code
0990-7902
11-Digit Billing Format
00990790203
RxNorm Crosswalk
  • RxCUI: 1863605 - potassium chloride 20 MEQ / dextrose 5 % / sodium chloride 0.45 % in 1000 ML Injection
  • RxCUI: 1863605 - 1000 ML glucose 50 MG/ML / potassium chloride 0.02 MEQ/ML / sodium chloride 4.5 MG/ML Injection
  • RxCUI: 1863605 - 1000 ML Glucose 50 MG/ML / K+ Chloride 0.02 MEQ/ML / NaCl 4.5 MG/ML Injection
  • RxCUI: 1863605 - 1000 ML Glucose 50 MG/ML / Pot Chloride 0.02 MEQ/ML / NaCl 4.5 MG/ML Injection
  • RxCUI: 1863605 - potassium chloride 20 MEQ / dextrose 5 % / sodium chloride 0.45 % per 1000 ML Injection

Clinical Specifications

Proprietary Name
Potassium Chloride In Dextrose And Sodium Chloride
Non-Proprietary Name
Dextrose Monohydrate, Sodium Chloride, And Potassium Chloride
Substance Name
Dextrose Monohydrate; Potassium Chloride; Sodium Chloride
Dosage Form
Injection, Solution - A liquid preparation containing one or more drug substances dissolved in a suitable solvent or mixture of mutually miscible solvents that is suitable for injection.
Administration Route
Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)
Pharmacologic Class
Usage Information
These solutions are indicated in patients requiring parenteral administration of potassium chloride with minimal carbohydrate calories and sodium chloride.

Regulatory & Marketing

Labeler Name
Icu Medical Inc.
Product Type
Human Prescription Drug
FDA Application #
NDA018362
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
02-01-2020
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Other Available Packages

The following commercial packages are registered under the same Product NDC (0990-7902). Click a package code to view its specific billing and regulatory data.

0990-7902-09
12 POUCH in 1 CASE / 1 BAG in 1 POUCH / 1000 mL in 1 BAG

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 0990-7902-03 identifies a specific commercial package of 24 pouch in 1 case / 1 bag in 1 pouch / 500 ml in 1 bag of Potassium Chloride In Dextrose And Sodium Chloride, a human prescription drug labeled by Icu Medical Inc.. This injection, solution is formulated for intravenous use and contains dextrose monohydrate; potassium chloride; sodium chloride as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Icu Medical Inc. on February 01, 2020. The current certification is valid through December 31, 2026.

How is this Icu Medical Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00990790203. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (4-4-2)
0990-7902-03
11-Digit CMS (5-4-2)
00990-7902-03

Note: The zero is added to the Labeler segment to maintain the 5-4-2 structure.