Code: Q9965

Description:
Description: Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
Contr Locm 100-199mg 1ml
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION
HC LOCM 100-199 MG/ML IODINE CONCENTRATION PER ML
LOCM 100-199 MG/ML 100ML
LOCM 100-199 MG/ML 150ML
LOCM 100-199 MG/ML 50ML
LOCM 100-199 MG/ML 300ML
1ML PER 1CC OMNIPAQUE CONTRAST AGENT CONCENTRATION 180
IOHEXOL INJ 180 PER 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: Q9963
GASTROGRAFN PO 367 120ML
Code: Q9964
HOCM 400 OR MORE 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
Alabama
Hospital Address Code Price Last Updated
Baptist East 400 Taylor Rd, Montgomery Q9965 $4 [source] 3 years ago
Baptist South 2105 E South Blvd, Montgomery Q9965 $4 [source] 3 years ago
Prattville Baptist 124 S Memorial Dr, Prattville Q9965 $4 [source] 3 years ago
Coosa Valley Medical Center 315 W Hickory St, Sylacauga Q9965 $4 [source] 3 years ago
Choctaw General Hospital 401 Vanity Fair Lane, Butler Q9965 $5 [source] 3 years ago
Bibb Medical Center 208 Pierson Ave, Centreville Q9965 $118 [source] 3 years ago
Brookwood Baptist Medical Center 2010 Brookwood Medical Ctr Dr, Birmingham Q9965 $178 [source] 3 years ago
Vaughan Regional Medical Center 1015 Medical Center Parkway, Waterbury Q9965 $6,863 [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.