Code: Q9963

Description:
Description: High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
GASTROGRAFN PO 367 30ML
HOCM 350-399 IC 1ML
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION
GASTROVIEW CONTRAST
Gastrografin 66+AC0-10+ACU- 120 Ml
Related codes:
Code: Q9960
HOCM 200-249 IC 1ML
Code: Q9961
HOCM 250-299 IC 50ML
Code: Q9962
HOCM 300-349 IC 50ML
Code: Q9964
HOCM 400 OR MORE IC 1ML
Code: Q9965
LOCM 100-199 IC 1ML
Code: Q9966
LOCM 200-299 IC 50ML
Code: Q9967
LOCM 300-399 IC 50ML
Code: Q9968
METHYL BLUE 100 MG INJ
Code: Q9969
TC99M NON-HEU ADD-ON
Nevada
Hospital Address Code Price Last Updated
Valley Hospital Medical Center 620 Shadow Lane, Las Vegas Q9963 $18 [source] 3 years ago
Carson Valley Medical Center 1107 Hwy 395, Gardnerville Q9963 $31 [source] 3 years ago
Boulder City Hospital 901 Adams Blvd, Boulder City Q9963 $146 [source] 3 years ago
Northeastern Nevada Regional Hospital 2001 Errecart Boulevard, Q9963 $189 [source] 3 years ago
Renown Regional Medical Center 1155 Mill Street, Reno Q9963 $203 [source] 3 years ago
Renown South Meadows Medical Center 10101 Double R Blvd, Reno Q9963 $203 [source] 3 years ago
Southern Hills Hospital & Medical Center 9300 W Sunset Rd, Las Vegas Q9963 $323 [source] 3 years ago
Mountainview Hospital 3100 N Tenaya Way, Las Vegas Q9963 $420 [source] 3 years ago
Sunrise Hospital & Medical Center 3186 S Maryland Pkwy, Las Vegas Q9963 $492 [source] 3 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.