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
Michigan
Hospital Address Code Price Last Updated
Mclaren Oakland 50 N Perry St, Pontiac A4641 $21 [source] 4 years ago
Botsford General Hospital 28050 Grand River Ave, Farmington A4641 $28 [source] 4 years ago
Botsford Continuing Care Corporation 21450 Archwood Cir, Farmington A4641 $28 [source] 4 years ago
Up Health System – Bell 901 Lakeshore Drive, Ishpeming A4641 $92 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens A4641 $179 [source] 4 years ago
Mclaren Bay Region 1900 Columbus Ave, Bay City A4641 $283 [source] 4 years ago
Mclaren Bay Special Care Hospital 3250 E Midland Rd Suite 1, Bay City A4641 $283 [source] 4 years ago
Mclaren Thumb Region 1100 S Van Dyke Rd, Bad Axe A4641 $302 [source] 4 years ago
Up Health System – Marquette 580 West College Avenue, Marquette A4641 $747 [source] 4 years ago
Mclaren Lapeer Region 1375 N Main St, Lapeer A4641 $1,293 [source] 4 years ago
Mclaren Flint 401 S Ballenger Hwy, Flint A4641 $2,294 [source] 4 years ago
Karmanos Cancer Institute 4100 John R St, Detroit A4641 $3,342 [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.