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
North Carolina
Hospital Address Code Price Last Updated
Harris Regional Hospital 68 Hospital Road, Sylva Q9963 $10 [source] 3 years ago
Adventhealth Hendersonville 100 Hospital Dr, Hendersonville Q9963 $36 [source] 3 years ago
Wilson Medical Center 1705 Tarboro Street Sw, Wilson Q9963 $44 [source] 3 years ago
Carepartners Rehabilitation Hospital 68 Sweeten Creek Rd, Asheville Q9963 $612 [source] 3 years ago
Mcdowell Hospital , Marion Q9963 $661 [source] 3 years ago
Blue Ridge Regional Hospital 125 Hospital Dr, Spruce Pine Q9963 $661 [source] 3 years ago
Angel Medical Center 120 Riverview St, Franklin Q9963 $661 [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 ยง180.