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

Utah

Hospital	Address	Code	Price	Last Updated
Garfield Memorial Clinic	200 N 400 E, Panguitch	Q9963	$1 [source]	3 years ago
Mountainstar Healthcare	6985 Union Park Center, Suite 500, Midvale	Q9963	$227 [source]	3 years ago
Castleview Hospital	300 North Hospital Drive, Price	Q9963	$231 [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.