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
Wisconsin
Hospital Address Code Price Last Updated
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy A4641 $80 [source] 4 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh A4641 $80 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee A4641 $80 [source] 4 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette A4641 $80 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc A4641 $80 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay A4641 $80 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee A4641 $80 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington A4641 $80 [source] 4 years ago
Aurora Lakeland Medical Center W3930 County Road Nn, Elkhorn A4641 $80 [source] 4 years ago
Prairie Ridge Health 1515 Park Ave, Columbus A4641 $588 [source] 4 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton A4641 $3,650 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford A4641 $3,650 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee A4641 $3,650 [source] 4 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers A4641 $3,650 [source] 4 years ago
Watertown Regional Medical Center 125 Hospital Drive, Watertown A4641 $4,394 [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.