Code: A4641

Description:
Description: Radiopharmaceutical, diagnostic, not otherwise classified
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Other Descriptions:
HC RADIOPHARMACEUTICAL DIAGNOSTIC NOC
DX RADIOPHARMACEUTICAL, NW 1
SUPPLY, RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT
ULTRATAG RBC KIT
CARBON 14 UREA, 0.001MCI PER 1 MICROCURIE
DX RADIOPHARMACEUTICAL, NW 3
RADIOPHARMACEUTICAL DIAGNOSTIC NOC
TC99M HEAT DAMAGED RBCS PER DOSE 5MCI
TC99M PLATELETS PER DOSE 20MCI
Related codes:
Code: A4640
Description: Replacement pad for use with medically necessary alternating pressure pad owned by patient
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Code: A4642
SATUMOMAB PENDETIDE 6MCI
Code: A4644
OBSOLETE OMNIPAQUE,NON-IONIC 140MG/50ML SDV.
Code: A4645
OBSOLETE OMNIPAQUE,NON-IONIC 240MG/10ML SDV.
Code: A4646
MARKER DIAG 12CM XSHAPE
Code: A4647
OBSOLETE MAGNEVIST (FOR MRI) 10ML/VIAL.
Code: A4648
MARKER BIOZRB TISS 3X3CM
Code: A4649
Description: Surgical supply
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Illinois
Hospital Address Code Price Last Updated
Adventist Bolingbrook Hospital 500 Remington Blvd, Bolingbrook A4641 $195 [source] 4 years ago
Presence St. Mary's Hospital 500 W Court St, Kankakee A4641 $260 [source] 4 years ago
Alexian Brothers Medical Center 935 Beisner Rd, Elk Grove Village A4641 $341 [source] 4 years ago
Adventist Hinsdale Hospital 120 N Oak St, Hinsdale A4641 $350 [source] 4 years ago
Adventist Lagrange Memorial Hospital 5101 Willow Springs Rd, La Grange A4641 $353 [source] 4 years ago
Adventist Glenoaks Hospital 701 Winthrop Ave, Glendale Heights A4641 $353 [source] 4 years ago
St. Alexius Medical Center 1555 Barrington Road, A4641 $354 [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.