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
South Carolina
Hospital Address Code Price Last Updated
Providence Health 2435 Forest Drive, Columbia Q9963 $3 [source] 3 years ago
Providence Health Northeast 120 Gateway Corporate Blvd, Columbia Q9963 $3 [source] 3 years ago
Aiken Regional Medical Centers 302 University Parkway, Aiken Q9963 $23 [source] 3 years ago
Colleton Medical Center 501 Robertson Blvd, Walterboro Q9963 $39 [source] 3 years ago
Grand Strand Medical Center 809 82Nd Pkwy, Myrtle Beach Q9963 $306 [source] 3 years ago
Trident Medical Center 9330 Medical Plaza Dr., Charleston Q9963 $1,210 [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.