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
Texas
Hospital Address Code Price Last Updated
Ennis Regional Medical Center 2201 West Lampasas, Waxahachie A4641 $61 [source] 4 years ago
Texoma Medical Center 5016 South Us Highway 75, Denison A4641 $317 [source] 4 years ago
Rio Grande Regional Hospital 101 East Ridge Road, Mcallen A4641 $371 [source] 4 years ago
Medical City North Hills 4401 Booth Calloway Rd, North Richland Hills A4641 $378 [source] 4 years ago
Parkview Regional Hospital 600 South Bonham Street, Mexia A4641 $444 [source] 4 years ago
Medical City Dallas 13155 Noel Rd. Suite 200, Dallas A4641 $971 [source] 4 years ago
Medical City Lewisville 500 W Main St, Lewisville A4641 $1,429 [source] 4 years ago
Palestine Regional Medical Center 2900 South Loop 256, Palestine A4641 $1,918 [source] 4 years ago
Texas Health Huguley 11801 South Fwy, Burleson A4641 $2,145 [source] 4 years ago
Medical City Las Colinas 6800 N Macarthur Blvd, Irving A4641 $3,164 [source] 4 years ago
South Texas Health System Heart 1900 South D Street, Mcallen A4641 $3,900 [source] 4 years ago
South Texas Health System Mcallen 301 W. Expressway 83, Mcallen A4641 $3,900 [source] 4 years ago
South Texas Health System Children’s 1102 W. Trenton Road, Edinburg A4641 $3,900 [source] 4 years ago
Northwest Texas Healthcare System 1501 S. Coulter, Amarillo A4641 $4,921 [source] 4 years ago
Adventhealth Central Texas 2201 Clear Creek Rd, Killeen A4641 $5,340 [source] 4 years ago
Adventhealth Rollins Brook 608 N Key Ave, Lampasas A4641 $5,340 [source] 4 years ago
Medical City Arlington 3301 Matlock Rd, Arlington A4641 $10,441 [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.