Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

MARY HITCHCOCK MEMORIAL HOSPITAL

NPI: 1023092053 · LEBANON, NH 03756 · Internal Medicine Physician · NPI assigned 12/02/2005

$32.31M
Total Medicaid Paid
1,291,441
Total Claims
1,034,153
Beneficiaries
540
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialJANTZEN, DANIEL (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date12/02/2005

Related Entities

Other providers sharing the same authorized official: JANTZEN, DANIEL

ProviderCityStateTotal Paid
DARTMOUTH-HITCHCOCK CLINIC LEBANON NH $31.39M
DARTMOUTH-HITCHCOCK CLINIC KEENE NH $606K
DARTMOUTH-HITCHCOCK CLINIC LEBANON NH $93K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 244,485 $5.44M
2019 294,002 $6.12M
2020 214,933 $4.75M
2021 213,845 $5.37M
2022 211,544 $5.58M
2023 72,580 $2.97M
2024 40,052 $2.08M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 105,611 88,140 $5.76M
A0431 Ambulance service, conventional air services, transport, one way (rotary wing) 1,760 1,220 $2.87M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 50,195 43,699 $2.01M
99215 Prolong outpt/office vis 13,179 11,287 $925K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 3,939 3,113 $891K
99284 Emergency department visit for the evaluation and management, high severity 5,199 4,091 $817K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 1,744 1,419 $741K
G0378 Hospital observation service, per hour 5,487 2,105 $713K
74177 Computed tomography, abdomen and pelvis; with contrast material 1,776 1,470 $644K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 12,973 11,320 $625K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 6,327 5,851 $592K
J1745 Injection, infliximab, excludes biosimilar, 10 mg 361 248 $489K
70551 Magnetic resonance imaging, brain; without contrast material 1,098 863 $433K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 46,734 29,111 $424K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 7,630 6,892 $417K
A0436 Rotary wing air mileage, per statute mile 587 469 $408K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 5,191 2,955 $370K
88305 Level IV - Surgical pathology, gross and microscopic examination 10,093 8,485 $344K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,296 1,100 $325K
84443 Thyroid stimulating hormone (TSH) 31,230 27,290 $306K
80053 Comprehensive metabolic panel 48,058 39,408 $304K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 8,132 5,354 $291K
J0585 Injection, onabotulinumtoxina, 1 unit 1,220 620 $288K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,214 1,032 $274K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 7,157 5,088 $273K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 60,375 46,653 $266K
99283 Emergency department visit for the evaluation and management, moderate severity 2,086 1,820 $255K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 12,400 10,597 $255K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 12,371 10,579 $252K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,161 909 $238K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 11,647 10,318 $226K
70450 Computed tomography, head or brain; without contrast material 1,246 991 $202K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 1,435 1,268 $194K
80061 Lipid panel 18,475 16,788 $184K
J9271 Injection, pembrolizumab, 1 mg 57 36 $179K
96375 Therapeutic injection; each additional sequential IV push 5,078 2,982 $170K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 7,209 6,415 $163K
87631 2,387 2,156 $154K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 6,247 4,389 $145K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 2,523 1,610 $144K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 2,350 992 $141K
92060 4,159 3,775 $135K
96361 Intravenous infusion, hydration; each additional hour 2,016 1,272 $124K
95810 Polysomnography; sleep staging with 4 or more additional parameters 832 571 $123K
71046 Radiologic examination, chest; 2 views 3,178 2,492 $118K
83036 Hemoglobin; glycosylated (A1C) 17,528 15,757 $117K
81229 410 305 $111K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 6,974 5,289 $107K
99244 Office or other outpatient consultation, moderate to high complexity 1,332 1,256 $106K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 675 535 $99K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 4,420 4,150 $91K
99205 Prolong outpt/office vis 822 766 $91K
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants 494 445 $90K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 3,144 2,268 $87K
99243 1,232 1,196 $86K
76770 927 777 $86K
J2704 Injection, propofol, 10 mg 9,483 7,019 $85K
82728 8,982 7,852 $84K
80048 Basic metabolic panel (calcium, ionized) 18,515 13,926 $84K
96112 1,027 946 $79K
92567 8,152 7,770 $77K
84439 11,930 10,390 $76K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 4,189 3,355 $75K
93325 888 729 $70K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 6,352 4,941 $69K
86003 1,595 1,189 $69K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 5,711 2,224 $68K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 6,836 6,599 $67K
76705 Ultrasound, abdominal, real time with image documentation; limited 879 742 $66K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 874 689 $63K
86803 6,083 5,491 $63K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 1,478 1,429 $62K
87522 Neg quan hep c or qual rna 1,863 1,658 $61K
90792 Psychiatric diagnostic evaluation with medical services 970 759 $60K
83970 2,553 2,145 $59K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 236 193 $57K
84702 4,790 3,635 $55K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 729 708 $55K
87536 1,307 1,182 $55K
96415 1,398 834 $54K
87086 Culture, bacterial; quantitative colony count, urine 11,841 9,783 $54K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 730 703 $53K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 123 106 $52K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,072 1,733 $52K
A9575 Injection, gadoterate meglumine, 0.1 ml 3,454 2,721 $52K
86480 1,179 1,061 $50K
82607 6,407 5,643 $50K
82784 6,066 4,350 $50K
36415 Collection of venous blood by venipuncture 110,412 89,260 $49K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 794 430 $49K
94010 1,805 1,598 $49K
86780 4,924 4,290 $48K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 1,755 1,508 $48K
83516 4,802 4,032 $47K
83550 7,636 6,704 $45K
92015 Determination of refractive state 4,961 3,851 $44K
99282 Emergency department visit for the evaluation and management, low to moderate severity 583 501 $44K
87070 6,517 5,726 $44K
78815 Positron emission tomography (PET) for limited area imaging 62 56 $44K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 2,796 1,022 $43K
72141 129 113 $43K
86850 5,413 4,334 $43K
80076 8,154 6,810 $43K
64615 740 468 $42K
85027 8,789 7,708 $42K
84403 2,236 1,948 $41K
92582 1,049 1,023 $41K
67028 Intravitreal injection of a pharmacologic agent 543 417 $41K
86235 603 531 $39K
73560 744 609 $39K
88341 745 629 $39K
87340 5,323 4,698 $38K
83655 3,678 3,304 $38K
87077 5,288 4,503 $36K
99245 348 328 $36K
90834 Psychotherapy, 45 minutes with patient 921 413 $34K
83540 7,772 6,823 $34K
71250 253 218 $33K
D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth 519 448 $31K
31231 424 344 $31K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 3,229 2,013 $30K
73610 736 585 $30K
82746 3,058 2,689 $30K
80050 General health panel 3,938 3,821 $29K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 982 895 $29K
93017 299 238 $28K
87186 4,435 3,731 $28K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 3,759 1,767 $28K
86140 7,980 6,802 $27K
71275 Computed tomographic angiography, chest, with contrast material 93 81 $27K
95816 196 159 $27K
93000 1,962 1,891 $27K
92134 3,334 1,920 $26K
92556 1,088 1,059 $26K
83880 1,815 1,454 $26K
90847 Family psychotherapy with the patient present, 50 minutes 382 282 $26K
92083 1,096 813 $25K
73030 722 548 $25K
J2469 Injection, palonosetron hcl, 25 mcg 1,065 596 $25K
73630 602 511 $25K
91120 113 88 $24K
86762 2,383 2,107 $24K
90460 Immunization administration through 18 years of age via any route, first or only component 1,361 1,270 $24K
86618 2,262 2,030 $24K
74183 65 54 $24K
82670 1,045 918 $22K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 318 289 $22K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 479 307 $22K
86706 2,801 2,480 $22K
82105 1,804 1,559 $22K
74018 411 313 $21K
94729 518 438 $21K
74176 Computed tomography, abdomen and pelvis; without contrast material 57 49 $21K
82570 5,535 4,709 $21K
83735 5,560 3,778 $21K
88342 1,933 1,615 $20K
99152 1,500 1,201 $20K
81001 9,305 7,685 $20K
90686 4,493 4,317 $20K
90837 Psychotherapy, 53 minutes with patient 539 175 $19K
97162 738 605 $19K
93226 220 188 $18K
83001 1,258 1,121 $18K
83690 4,242 3,509 $18K
85610 7,847 5,929 $18K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 499 407 $17K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 4,966 3,811 $17K
45380 Colonoscopy, flexible; with biopsy, single or multiple 93 68 $17K
84146 1,120 1,012 $17K
91322 128 126 $17K
72100 305 268 $17K
96411 237 145 $16K
93321 413 328 $16K
84402 911 853 $16K
96376 735 467 $16K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 373 312 $16K
A0425 Ground mileage, per statute mile 62 40 $16K
85652 8,430 7,274 $16K
71045 Radiologic examination, chest; single view 441 382 $16K
73110 358 264 $16K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 344 247 $15K
82043 4,036 3,594 $15K
86038 1,822 1,616 $15K
73130 310 250 $15K
99153 Mod sedat endo service >5yrs 1,323 1,034 $15K
87899 1,476 505 $15K
83993 775 737 $15K
92504 1,051 834 $15K
87905 1,266 1,137 $14K
J0690 Injection, cefazolin sodium, 500 mg 4,541 3,189 $14K
D7240 Removal of impacted tooth - completely bony 351 324 $14K
83002 958 859 $14K
97803 436 387 $14K
95811 79 55 $14K
87147 2,192 1,928 $13K
20610 295 231 $13K
86704 1,558 1,374 $13K
C1769 Guide wire 1,403 1,000 $13K
84153 1,288 1,150 $13K
88307 507 438 $13K
92250 890 665 $12K
96111 263 251 $12K
73502 407 335 $12K
83520 1,225 1,096 $12K
77067 Screening mammography, bilateral, including computer-aided detection 192 176 $12K
84484 2,124 1,487 $11K
95953 38 31 $11K
81329 463 422 $11K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 70 62 $11K
82565 3,645 2,996 $10K
J7120 Ringers lactate infusion, up to 1000 cc 12,576 8,667 $10K
86376 989 893 $10K
86900 5,436 4,362 $10K
82950 2,840 2,532 $10K
96417 334 186 $10K
76830 Ultrasound, transvaginal 121 100 $10K
99417 Prolong home eval add 15m 123 89 $10K
86901 5,436 4,362 $10K
87081 2,183 1,979 $10K
95117 1,082 768 $10K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 8,239 5,673 $10K
84305 746 688 $10K
85730 2,847 2,333 $10K
82977 1,813 1,566 $9K
86708 1,068 962 $9K
93296 726 583 $9K
83615 3,222 2,318 $9K
97161 490 446 $9K
82962 5,681 3,089 $9K
84100 3,890 2,858 $9K
J0185 Injection, aprepitant, 1 mg 103 68 $9K
86160 678 548 $9K
91122 113 88 $9K
86255 727 630 $9K
J2405 Injection, ondansetron hydrochloride, per 1 mg 10,021 6,898 $9K
84165 1,209 1,023 $9K
80164 1,028 824 $9K
17110 167 157 $9K
59025 Fetal non-stress test 188 127 $8K
86225 838 771 $8K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 71 63 $8K
J7050 Infusion, normal saline solution, 250 cc 10,855 6,064 $8K
82274 753 704 $8K
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) 417 382 $8K
81003 6,527 5,548 $8K
76942 103 87 $8K
91200 549 448 $8K
90472 Immunization administration, each additional vaccine (list separately) 690 677 $8K
84480 794 711 $8K
96119 86 54 $8K
84460 2,159 1,868 $8K
G0399 Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation 58 53 $8K
82533 604 526 $8K
99001 1,719 1,534 $8K
87205 2,438 2,036 $7K
86039 898 786 $7K
87102 1,259 1,091 $7K
86787 818 722 $7K
84156 3,030 2,407 $7K
81025 1,717 1,413 $7K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 325 279 $7K
84163 577 536 $7K
93922 198 171 $7K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 2,657 2,175 $7K
90791 Psychiatric diagnostic evaluation 80 72 $6K
70355 395 362 $6K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 6,170 4,499 $6K
81401 379 325 $6K
84450 1,689 1,425 $6K
92579 238 223 $6K
82550 1,502 1,222 $6K
86800 649 578 $6K
72040 160 129 $6K
86200 629 585 $6K
88304 335 303 $6K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 74 73 $6K
86431 1,409 1,266 $6K
82803 483 385 $6K
85018 3,144 2,744 $6K
73522 91 84 $6K
84550 2,181 1,794 $6K
82247 1,702 1,350 $6K
96132 105 64 $5K
J3010 Injection, fentanyl citrate, 0.1 mg 9,652 6,725 $5K
92557 207 200 $5K
72082 76 74 $5K
83883 837 509 $5K
96139 44 27 $5K
86696 355 328 $5K
77336 85 27 $5K
S0020 Injection, bupivicaine hydrochloride, 30 ml 2,515 1,887 $5K
81002 2,036 1,867 $5K
82677 266 230 $5K
87902 81 73 $5K
64405 160 91 $5K
82040 2,103 1,749 $5K
82248 1,448 1,164 $5K
82947 1,817 1,620 $5K
84425 320 278 $5K
A0434 Specialty care transport (sct) 14 13 $5K
82310 1,505 1,251 $4K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 96 52 $4K
84481 357 324 $4K
98940 274 159 $4K
98941 Chiropractic manipulative treatment; spinal, 3-4 regions 232 127 $4K
85046 1,864 1,425 $4K
84520 1,737 1,453 $4K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 464 116 $4K
96133 37 26 $4K
31575 84 55 $4K
91010 48 31 $4K
72146 17 15 $4K
80175 590 485 $4K
72125 Computed tomography, cervical spine; without contrast material 31 25 $4K
82627 202 193 $4K
86695 355 328 $4K
86359 450 373 $3K
87046 512 481 $3K
87045 500 469 $3K
J1756 Injection, iron sucrose, 1 mg 108 56 $3K
77002 116 83 $3K
83718 589 511 $3K
82150 793 681 $3K
83010 384 327 $3K
86336 269 233 $3K
88185 29 25 $3K
80177 436 352 $3K
82785 244 232 $3K
85379 477 424 $3K
84075 978 824 $3K
J0475 Injection, baclofen, 10 mg 16 13 $3K
83721 783 684 $3K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 2,389 1,482 $3K
0071A 139 130 $3K
96409 37 26 $3K
0072A 135 131 $3K
87328 284 266 $3K
J2250 Injection, midazolam hydrochloride, per 1 mg 7,429 5,684 $3K
84590 321 307 $3K
90480 169 166 $3K
91038 20 14 $3K
84630 351 312 $3K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 15 13 $3K
83498 121 116 $3K
70486 15 13 $3K
87040 312 259 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 232 154 $3K
87075 366 310 $3K
86308 590 541 $3K
J7030 Infusion, normal saline solution , 1000 cc 3,785 2,167 $2K
96138 90 52 $2K
86361 329 269 $2K
87329 318 297 $2K
97535 Self-care/home management training, each 15 minutes 119 77 $2K
85014 1,338 1,123 $2K
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 1,512 1,165 $2K
91065 58 51 $2K
J1170 Injection, hydromorphone, up to 4 mg 2,433 1,520 $2K
82378 171 123 $2K
86769 65 59 $2K
76499 174 114 $2K
73552 46 41 $2K
87206 503 441 $2K
0124A 97 97 $2K
93971 32 29 $2K
17311 23 13 $2K
90461 109 103 $2K
86665 85 80 $2K
80069 277 250 $2K
99242 42 42 $2K
0134A 90 90 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg 5,283 3,544 $2K
82131 223 194 $2K
96118 17 14 $2K
95700 13 12 $2K
82172 133 124 $2K
88312 91 79 $2K
81243 31 27 $2K
87486 70 62 $2K
87581 70 62 $2K
84132 898 771 $2K
87015 445 343 $2K
82465 668 582 $2K
C1893 Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away 169 135 $2K
84155 797 676 $2K
69210 70 55 $2K
91037 43 28 $2K
82951 160 156 $2K
87529 43 41 $2K
89051 589 324 $2K
84295 779 681 $2K
Q3014 Telehealth originating site facility fee 1,078 863 $2K
90656 374 359 $2K
99495 16 15 $2K
97802 39 38 $2K
97163 28 25 $1K
0074A 77 77 $1K
82435 733 639 $1K
D7230 25 24 $1K
90846 Family psychotherapy without the patient present, 50 minutes 25 13 $1K
J1644 Injection, heparin sodium, per 1000 units 1,329 738 $1K
82542 115 95 $1K
0064A 52 51 $1K
83605 233 199 $1K
97530 Therapeutic activities, direct patient contact, each 15 minutes 124 66 $1K
80197 388 256 $1K
95874 130 75 $1K
64642 12 12 $1K
0054A 58 52 $1K
82390 139 131 $1K
96367 34 26 $1K
92133 74 64 $1K
74019 17 12 $1K
83630 95 89 $1K
90717 13 13 $1K
88184 34 27 $994.29
86664 85 80 $984.27
82374 499 434 $961.24
82657 56 37 $948.26
0001A 31 31 $941.10
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 14 13 $929.40
J3490 Unclassified drugs 2,782 1,518 $892.80
92225 123 55 $888.78
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 31 30 $888.76
J2795 Injection, ropivacaine hydrochloride, 1 mg 34 24 $869.40
99407 55 41 $858.61
G0127 Trimming of dystrophic nails, any number 101 91 $811.84
T1023 Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter 27 26 $796.82
95251 82 67 $794.85
0004A 39 38 $789.42
72081 13 12 $780.48
80081 16 15 $767.30
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 42 24 $764.24
C1729 Catheter, drainage 54 37 $753.85
80051 145 119 $753.64
86022 51 42 $727.94
83525 86 81 $713.60
51798 98 90 $702.21
96167 15 12 $688.73
88321 34 31 $676.44
92552 38 37 $634.43
99281 Emergency department visit for the evaluation and management, self-limited or minor 15 14 $624.38
80055 54 28 $615.56
0052A 29 27 $605.72
92226 129 57 $574.87
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 42 39 $566.95
82340 163 128 $552.44
83521 26 12 $552.00
84445 12 12 $535.77
0154A 26 26 $532.61
82140 65 52 $519.14
77063 Screening digital breast tomosynthesis, bilateral 191 175 $518.76
86364 12 12 $515.08
92551 79 77 $512.97
87338 57 51 $505.86
87449 64 57 $502.30
82952 160 156 $501.35
87324 61 55 $492.35
62370 18 13 $486.03
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 171 155 $468.95
84478 113 94 $464.53
84436 150 117 $464.52
73590 15 12 $441.19
92202 122 72 $414.29
82103 44 42 $409.45
83020 40 37 $407.66
J7060 5% dextrose/water (500 ml = 1 unit) 731 386 $405.85
99442 68 36 $400.68
92526 12 12 $400.46
D7140 Extraction, erupted tooth or exposed root 12 12 $393.75
96156 32 32 $391.57
95886 19 13 $388.37
94664 40 40 $373.31
86341 12 12 $366.80
84134 54 41 $361.68
96127 136 103 $346.27
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,130 751 $342.95
88313 46 36 $323.98
81479 Unlisted molecular pathology procedure 12 12 $321.94
82525 28 28 $286.98
99443 28 16 $256.30
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 189 130 $251.72
0111A 13 13 $248.46
99188 33 31 $230.12
85240 14 14 $218.05
99173 79 77 $207.62
0081A 13 13 $197.38
83789 14 12 $196.69
C1887 Catheter, guiding (may include infusion/perfusion capability) 63 50 $187.06
94760 76 62 $184.39
G0008 Administration of influenza virus vaccine 602 473 $182.95
S0077 Injection, clindamycin phosphate, 300 mg 38 28 $180.34
J0780 Injection, prochlorperazine, up to 10 mg 69 53 $164.65
J1030 Injection, methylprednisolone acetate, 40 mg 73 61 $164.44
88173 14 12 $163.97
J0330 Injection, succinylcholine chloride, up to 20 mg 112 43 $146.31
G0444 Annual depression screening, 5 to 15 minutes 13 12 $132.80
J0696 Injection, ceftriaxone sodium, per 250 mg 145 102 $119.19
84446 13 13 $118.85
85049 53 41 $103.13
90653 47 35 $81.65
J1650 Injection, enoxaparin sodium, 10 mg 56 13 $78.02
J8540 Dexamethasone, oral, 0.25 mg 73 37 $74.50
97012 16 12 $68.89
J3475 Injection, magnesium sulfate, per 500 mg 31 24 $66.68
84300 18 12 $59.40
99201 27 17 $44.06
82945 19 12 $44.00
84157 19 12 $40.56
J2270 Injection, morphine sulfate, up to 10 mg 55 37 $35.97
C9257 Injection, bevacizumab, 0.25 mg 32 26 $31.14
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 42 30 $28.92
99411 17 15 $25.15
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 20 12 $22.35
J2060 Injection, lorazepam, 2 mg 75 41 $21.38
81000 12 12 $14.94
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 17 16 $9.10
C1758 Catheter, ureteral 16 12 $6.16
91307 393 365 $1.72
91305 175 162 $0.92
91312 97 97 $0.65
91313 90 90 $0.59
91300 126 122 $0.55
91308 69 65 $0.35
91306 51 50 $0.25
91311 28 28 $0.18
91315 26 26 $0.17
90694 12 12 $0.00
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 46 25 $0.00
96040 117 108 $0.00
90698 55 53 $0.00
90697 12 12 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 289 190 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 965 752 $0.00
90670 69 66 $0.00
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 18 18 $0.00
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 295 194 $0.00
90662 43 37 $0.00
80364 24 12 $0.00
90633 27 27 $0.00