Code: Q9966

Description:

Description: Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)

Other Descriptions:

OMNIPAQUE PO 240 50ML

LOCM 200-299 IC 1ML

LOCM 200-299 IC 20ML

OMNIPAQUE PO 240 150ML

LOCM 200-299 IC 200ML

LOCM 200-299 IC 150ML

Cntrst Rad Ompq 240 100ml

Locm 250-299 Mg/ml Per Ml

Omnipaque 240 / 200 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: 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: 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)

Tennessee

Hospital	Address	Code	Price	Last Updated
St. Jude Children's Research Hospital	, Memphis	Q9966	$1 [source]	4 years ago
Riverview Regional Medical Center	158 Hospital Drive, Carthage	Q9966	$2 [source]	4 years ago
Sumner Regional Medical Center	555 Hartsville Pike, Gallatin	Q9966	$4 [source]	4 years ago
Southern Tennessee Regional Health System - Pulaski	1265 East College Street, Pulaski	Q9966	$8 [source]	4 years ago
Trousdale Medical Center	500 Church Street, Hartsville	Q9966	$8 [source]	4 years ago
Starr Regional Medical Center - Athens	1114 West Madison Ave, Athens	Q9966	$131 [source]	4 years ago
Starr Regional Medical Center - Etowah	886 Highway 411 North, Etowah	Q9966	$131 [source]	4 years ago
Southern Tennessee Regional Health System - Winchester	185 Hospital Road, Winchester	Q9966	$457 [source]	4 years ago
Southern Tennessee Regional Health System - Lawrenceburg	1607 South Locust Avenue, Lawrenceburg	Q9966	$826 [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.