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
Description: High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9961
Description: High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9962
Description: High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9964
Description: High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9965
Description: Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9966
Description: Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9967
Description: Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9968
Description: Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q9969
Description: Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose
HCPCS Category: Temporary codes (limited use and guidelines specific)
Georgia
Hospital Address Code Price Last Updated
Murray Medical Center, Inc. 104 Hospital Dr, Chatsworth Q9963 $1 [source] 4 years ago
Adventist Health System Georgia, Inc 170 Curtis Pkwy Ne, Calhoun Q9963 $1 [source] 4 years ago
Adventhealth Gordon 105 Willowbrook Way Se, Calhoun Q9963 $1 [source] 4 years ago
Adventist Health System Georgia Inc 1035 Red Bud Rd Ne, Calhoun Q9963 $1 [source] 4 years ago
Murray County Memorial Hospital Authority 707 Old Dalton Ellijay Rd, Chatsworth Q9963 $2 [source] 4 years ago
Wellstar Atlanta Medical Center 303 Parkway Dr Ne, Atlanta, Georgia, Atlanta Q9963 $2 [source] 4 years ago
Memorial Health 4700 Waters Avenue, Savannah Q9963 $161 [source] 4 years ago
Redmond Regional Medical Center 501 Redmond Rd, Rome Q9963 $180 [source] 4 years ago
Eastside Medical Center 1700 Medical Way, Snellville Q9963 $249 [source] 4 years ago
Emory University Hospital Decatur 2165 N Decatur Rd , Decatur Q9963 $255 [source] 4 years ago
Fairview Park Hospital 200 Industrial Boulevard, Dublin Q9963 $276 [source] 4 years ago
Coliseum Health System 350 Hospital Dr, Macon Q9963 $279 [source] 4 years ago
Cartersville Medical Center 960 Joe Frank Harris Pkwy, Cartersville Q9963 $1,067 [source] 4 years ago
Doctors Hospital Of Augusta 3651 Wheeler Rd, Augusta Q9963 $1,227 [source] 4 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.