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
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: Q9966
Description: Low osmolar contrast material, 200-299 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 Q9967 $1 [source] 4 years ago
Saint Francis Hospital - Memphis 5959 Park Ave., Memphis Q9967 $5 [source] 4 years ago
Saint Francis Hospital - Bartlett 2986 Kate Bond Rd., Memphis Q9967 $20 [source] 4 years ago
Riverview Regional Medical Center 158 Hospital Drive, Carthage Q9967 $111 [source] 4 years ago
Southern Tennessee Regional Health System - Pulaski 1265 East College Street, Pulaski Q9967 $204 [source] 4 years ago
Sumner Regional Medical Center 555 Hartsville Pike, Gallatin Q9967 $304 [source] 4 years ago
Southern Tennessee Regional Health System - Winchester 185 Hospital Road, Winchester Q9967 $535 [source] 4 years ago
Trousdale Medical Center 500 Church Street, Hartsville Q9967 $589 [source] 4 years ago
Starr Regional Medical Center - Athens 1114 West Madison Ave, Athens Q9967 $1,031 [source] 4 years ago
Starr Regional Medical Center - Etowah 886 Highway 411 North, Etowah Q9967 $1,031 [source] 4 years ago
Southern Tennessee Regional Health System - Lawrenceburg 1607 South Locust Avenue, Lawrenceburg Q9967 $1,094 [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.