Code: Q9967

Description:
Description: Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
LOCM 300-399 IC 30ML
OMNIPAQUE PO 350 100ML
LOCM 300-399 IC 1ML
LOCM 300-399 IC 200ML
OMNIPAQUE PO 350 50ML
OMNIPAQUE PO 300 50ML
LOCM 300-399 IC 10ML
LOCM 300-399 IC 100ML
LOCM 300-399 IC 75ML
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: Q9965
LOCM 100-199 IC 1ML
Code: Q9966
LOCM 200-299 IC 50ML
Code: Q9968
METHYL BLUE 100 MG INJ
Code: Q9969
TC99M NON-HEU ADD-ON
Idaho
Hospital Address Code Price Last Updated
St. Joseph Regional Medical Center 415 6Th St, Lewiston Q9967 $2 [source] 3 years ago
St. Joseph Regional Medical Center 415 Sixth Street, Lewiston Q9967 $2 [source] 3 years ago
Kootenai Health 2003 Kootenai Health Way, Coeur D Alene Q9967 $3 [source] 3 years ago
North Canyon Medical Center 267 North Canyon Drive, Gooding Q9967 $5 [source] 3 years ago
Lost Rivers Medical Center 551 Highland Dr, Arco Q9967 $21 [source] 3 years ago
Shoshone Medical Center 25 Jacobs Gulch Rd, Kellogg Q9967 $42 [source] 3 years ago
West Valley Medical Center 1717 Arlington Ave., Caldwell Q9967 $59 [source] 3 years ago
Eastern Idaho Regional Medical Center 3100 Channing Way, Idaho Falls Q9967 $62 [source] 3 years ago
Boundary Community Hospital 6640 Kaniksu St, Bonners Ferry Q9967 $263 [source] 3 years ago
West Valley Medical Center 3720 S Indiana Ave, Caldwell Q9967 $306 [source] 3 years ago
Bear Lake Memorial Hospital 164 S 5Th St, Montpelier Q9967 $313 [source] 3 years ago
Minidoka Medical Center 1308 8Th St, Suite 1, Rupert Q9967 $328 [source] 3 years ago
Power County Hospital 510 Roosevelt St, American Falls Q9967 $379 [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.