Code: Q9964

Description:

Description: High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Other Descriptions:

HIGH OSM CONTRST MATL 400/> MG/ML IODINE CONC ML

HC LOCM OMNI 350 100-199MG 200ML

HC HOCM CONRAY 60% 50 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: Q9963

Description: High osmolar contrast material, 350-399 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)

Illinois

Hospital	Address	Code	Price	Last Updated
Alexian Brothers Medical Center	935 Beisner Rd, Elk Grove Village	Q9964	$1 [source]	4 years ago
Adventist Hinsdale Hospital	120 N Oak St, Hinsdale	Q9964	$1 [source]	4 years ago
St. Alexius Medical Center	1555 Barrington Road,	Q9964	$1 [source]	4 years ago
Adventist Lagrange Memorial Hospital	5101 Willow Springs Rd, La Grange	Q9964	$1 [source]	4 years ago
Adventist Glenoaks Hospital	701 Winthrop Ave, Glendale Heights	Q9964	$1 [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 §180.