Code: Q9963

Description:

Description: High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Other Descriptions:

GASTROGRAFN PO 367 30ML

HOCM 350-399 IC 1ML

DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION

GASTROVIEW CONTRAST

Gastrografin 66+AC0-10+ACU- 120 Ml

Related codes:

Code: Q9960

HOCM 200-249 IC 1ML

Code: Q9961

HOCM 250-299 IC 50ML

Code: Q9962

HOCM 300-349 IC 50ML

Code: Q9964

HOCM 400 OR MORE IC 1ML

Code: Q9965

LOCM 100-199 IC 1ML

Code: Q9966

LOCM 200-299 IC 50ML

Code: Q9967

LOCM 300-399 IC 50ML

Code: Q9968

METHYL BLUE 100 MG INJ

Code: Q9969

TC99M NON-HEU ADD-ON

Indiana

Hospital	Address	Code	Price	Last Updated
Clark Memorial Health	1220 Missouri Avenue, Jeffersonville	Q9963	$1 [source]	3 years ago
Terre Haute Regional Hospital	3901 S 7Th St, Terre Haute	Q9963	$598 [source]	3 years ago
Franciscan Health Indianapolis	, Indianapolis	Q9963	$747 [source]	3 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR §180.