Code: Q9965

Description:
Description: Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
Contr Locm 100-199mg 1ml
IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION
HC LOCM 100-199 MG/ML IODINE CONCENTRATION PER ML
LOCM 100-199 MG/ML 100ML
LOCM 100-199 MG/ML 150ML
LOCM 100-199 MG/ML 50ML
LOCM 100-199 MG/ML 300ML
1ML PER 1CC OMNIPAQUE CONTRAST AGENT CONCENTRATION 180
IOHEXOL INJ 180 PER 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: Q9963
GASTROGRAFN PO 367 120ML
Code: Q9964
HOCM 400 OR MORE 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
Indiana
Hospital Address Code Price Last Updated
Ascension St. Vincent Warrick 1116 Millis Ave, Boonville Q9965 $1 [source] 3 years ago
Ascension St. Vincent Hospital 2001 W 86Th St, Indianapolis Q9965 $1 [source] 3 years ago
Ascension Medical Group St. Vincent 301 Henry St, North Vernon Q9965 $1 [source] 3 years ago
Ascension St. Vincent Evansville 3700 Washington Ave, Evansville Q9965 $1 [source] 3 years ago
Ascension St. Vincent Williamsport 412 N Monroe St, Williamsport Q9965 $1 [source] 3 years ago
St Vincent Salem Hospital Inc 911 N Shelby St, Salem Q9965 $1 [source] 3 years ago
St. Vincent Mercy Hospital 1331 S A St, Elwood Q9965 $1 [source] 3 years ago
Ascension St. Vincent Dunn 1600 23Rd St, Bedford Q9965 $1 [source] 3 years ago
Ascension St. Vincent Randolph 473 E Greenville Ave, Winchester Q9965 $1 [source] 3 years ago
Ascension St. Vincent Carmel 13500 N Meridian St, Carmel Q9965 $1 [source] 3 years ago
Ascension St. Vincent Anderson 2015 Jackson St, Anderson Q9965 $1 [source] 3 years ago
Ascension St. Vincent Heart Center 10580 N Meridian St, Indianapolis Q9965 $1 [source] 3 years ago
Terre Haute Regional Hospital 3901 S 7Th St, Terre Haute Q9965 $5 [source] 3 years ago
Franciscan Health Munster , Munster Q9965 $127 [source] 3 years ago
St. Vincent Clay Hospital, Inc 1206 E National Ave, Brazil Q9965 $6,012 [source] 3 years ago
Ascension St Vincent Fishers 13861 Olio Road, Q9965 $6,012 [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.