Medicaid Provider Spending

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

CARILION MEDICAL CENTER

NPI: 1033102942 · ROANOKE, VA 24014 · General Acute Care Hospital · NPI assigned 08/25/2005

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official PRESCOTT, ELEANOR controls 20+ related entities in our dataset. Read more

$124.86M
Total Medicaid Paid
2,897,971
Total Claims
2,065,897
Beneficiaries
589
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPRESCOTT, ELEANOR (GOVERNMENT PROGRAM MANAGER)
NPI Enumeration Date08/25/2005

Related Entities

Other providers sharing the same authorized official: PRESCOTT, ELEANOR

ProviderCityStateTotal Paid
CARILION MEDICAL CENTER ROANOKE VA $73.43M
CARILION HEALTHCARE CORPORATION ROANOKE VA $26.07M
CARILION MEDICAL CENTER ROANOKE VA $18.08M
CARILION ROCKBRIDGE COMMUNITY HOSPITAL LEXINGTON VA $11.82M
CARILION EMERGENCY SERVICES, INC. ROANOKE VA $11.09M
CARILION GILES COMMUNITY HOSPITAL PEARISBURG VA $10.32M
CARILION TAZEWELL COMMUNITY HOSPITAL TAZEWELL VA $8.03M
CARILION MEDICAL CENTER ROANOKE VA $7.31M
CARILION GILES COMMUNITY HOSPITAL PEARISBURG VA $2.40M
CARILION GILES COMMUNITY HOSPITAL MARTINSVILLE VA $1.99M
CARILION GILES COMMUNITY HOSPITAL GALAX VA $1.67M
CARILION GILES COMMUNITY HOSPITAL ROCKY MOUNT VA $1.14M
CARILION GILES COMMUNITY HOSPITAL WYTHEVILLE VA $880K
CARILION GILES COMMUNITY HOSPITAL FLOYD VA $697K
CARILION TAZEWELL COMMUNITY HOSPITAL TAZEWELL VA $677K
CARILION GILES COMMUNITY HOSPITAL TAZEWELL VA $379K
CARILION GILES COMMUNITY HOSPITAL HILLSVILLE VA $354K
CARILION ROCKBRIDGE COMMUNITY HOSPITAL BUCHANAN VA $322K
CARILION GILES COMMUNITY HOSPITAL PEARISBURG VA $254K
CARILION ROCKBRIDGE COMMUNITY HOSPITAL BEDFORD VA $241K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 314,402 $10.93M
2019 458,167 $16.83M
2020 400,141 $16.07M
2021 487,294 $18.89M
2022 421,483 $19.81M
2023 455,315 $22.67M
2024 361,169 $19.67M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 58,517 50,300 $10.30M
99283 Emergency department visit for the evaluation and management, moderate severity 58,239 51,427 $10.24M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 47,933 40,851 $8.45M
96361 Intravenous infusion, hydration; each additional hour 24,706 20,267 $7.22M
41899 Unlisted procedure, dentoalveolar structures 3,373 2,866 $4.22M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 5,709 5,310 $3.17M
74177 Computed tomography, abdomen and pelvis; with contrast material 13,158 12,025 $2.79M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 49,702 17,080 $2.66M
99282 Emergency department visit for the evaluation and management, low to moderate severity 15,289 13,826 $2.50M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 7,245 6,724 $2.31M
59899 2,669 2,141 $2.27M
70450 Computed tomography, head or brain; without contrast material 13,576 12,116 $2.24M
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 18,536 7,343 $2.24M
64493 1,969 1,779 $1.84M
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 5,390 5,063 $1.81M
77386 3,309 286 $1.68M
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 5,872 4,247 $1.59M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 10,641 8,968 $1.58M
99220 28,940 10,092 $1.38M
64483 1,826 1,716 $1.37M
97530 Therapeutic activities, direct patient contact, each 15 minutes 20,566 10,218 $1.31M
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 2,016 1,872 $1.28M
95810 Polysomnography; sleep staging with 4 or more additional parameters 2,040 1,913 $1.27M
62323 2,528 2,407 $1.27M
78815 Positron emission tomography (PET) for limited area imaging 1,612 1,491 $1.26M
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 16,090 14,703 $1.25M
45380 Colonoscopy, flexible; with biopsy, single or multiple 2,236 2,097 $1.22M
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 8,853 8,028 $1.21M
71275 Computed tomographic angiography, chest, with contrast material 5,911 5,451 $1.06M
76705 Ultrasound, abdominal, real time with image documentation; limited 9,660 8,957 $944K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 64,564 46,011 $918K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 19,394 16,490 $908K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 633 597 $884K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 9,586 7,936 $872K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,395 1,277 $871K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 3,855 3,647 $797K
97161 6,204 5,861 $796K
97162 6,997 6,374 $709K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 3,364 2,579 $695K
96415 2,278 1,752 $695K
74176 Computed tomography, abdomen and pelvis; without contrast material 3,701 3,371 $686K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,627 4,240 $671K
64635 895 670 $641K
59025 Fetal non-stress test 3,138 2,536 $627K
62321 1,156 1,096 $613K
76830 Ultrasound, transvaginal 5,409 5,029 $590K
43235 1,067 979 $577K
95806 1,078 1,056 $577K
99281 Emergency department visit for the evaluation and management, self-limited or minor 4,080 3,492 $572K
70551 Magnetic resonance imaging, brain; without contrast material 2,419 2,247 $555K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 7,243 5,519 $534K
97802 5,594 5,100 $504K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 4,631 3,197 $496K
72141 2,522 2,391 $468K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 2,001 1,867 $448K
77067 Screening mammography, bilateral, including computer-aided detection 7,972 7,767 $447K
74183 1,496 1,401 $433K
76642 4,020 3,518 $431K
70496 1,794 1,653 $424K
95811 792 707 $407K
71046 Radiologic examination, chest; 2 views 17,402 15,953 $404K
47563 115 106 $400K
93971 3,764 3,423 $389K
97803 4,210 3,729 $387K
92523 2,653 2,582 $366K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,498 2,234 $342K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 3,632 3,441 $340K
80053 Comprehensive metabolic panel 71,432 57,702 $333K
76770 2,255 2,153 $317K
93017 2,741 2,531 $305K
64494 2,016 1,539 $294K
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 6,198 3,381 $294K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 2,744 2,619 $290K
93308 1,041 956 $289K
36430 1,636 1,206 $286K
99215 Prolong outpt/office vis 1,215 1,130 $276K
77412 485 50 $272K
74174 1,250 1,172 $272K
74018 9,651 8,632 $269K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 5,466 4,844 $254K
Q5103 Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg 257 232 $248K
76536 2,035 1,923 $242K
99234 11,720 2,685 $241K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 366 350 $237K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 63,165 50,141 $237K
97166 3,230 2,879 $233K
72158 1,241 1,160 $233K
80048 Basic metabolic panel (calcium, ionized) 45,805 34,258 $229K
G0330 Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room 202 166 $225K
J1745 Injection, infliximab, excludes biosimilar, 10 mg 156 130 $222K
C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography 704 640 $218K
10060 1,771 1,596 $214K
12001 1,065 998 $212K
71250 3,115 2,897 $212K
78431 253 238 $211K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 5,260 2,360 $211K
77336 2,601 1,051 $210K
20680 164 140 $209K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 4,285 1,979 $207K
64636 852 587 $206K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,711 1,133 $201K
97165 1,880 1,747 $201K
71260 Computed tomography, thorax, diagnostic; with contrast material 3,643 3,375 $189K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,321 1,290 $188K
94060 2,961 2,726 $187K
49083 378 203 $186K
P9045 Infusion, albumin (human), 5%, 250 ml 695 545 $184K
19083 220 179 $183K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 3,080 2,561 $180K
20610 2,174 1,752 $171K
76801 1,831 1,711 $168K
P9016 Red blood cells, leukocytes reduced, each unit 577 496 $162K
99235 7,928 1,827 $160K
70491 958 910 $158K
93970 1,203 1,108 $155K
78492 204 179 $152K
73221 735 687 $152K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 1,069 989 $146K
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 10,472 8,842 $145K
97116 4,233 2,386 $144K
58661 57 39 $144K
92526 2,845 1,718 $144K
G0378 Hospital observation service, per hour 4,266 3,507 $142K
12011 670 631 $141K
76819 Fetal biophysical profile; without non-stress testing 1,412 967 $137K
42820 Tonsillectomy and adenoidectomy; younger than age 12 78 77 $136K
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 5,709 5,176 $132K
97113 2,326 1,006 $127K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 44,733 37,673 $124K
93880 1,287 1,192 $118K
93458 111 101 $118K
70498 2,015 1,857 $116K
76870 1,073 1,010 $115K
73130 5,884 4,129 $114K
97163 952 885 $110K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 107,699 80,519 $110K
92610 1,048 982 $109K
76700 Ultrasound, abdominal, real time with image documentation; complete 835 795 $107K
73630 5,946 4,629 $106K
77066 Tomosynthesis, mammo 2,556 2,394 $106K
72100 4,576 4,231 $103K
77065 Tomosynthesis, mammo 2,662 2,293 $101K
71045 Radiologic examination, chest; single view 28,622 24,800 $99K
90935 Hemodialysis procedure with single evaluation by a physician 201 80 $98K
72197 295 278 $95K
76641 784 699 $91K
97167 920 886 $90K
72125 Computed tomography, cervical spine; without contrast material 5,535 5,022 $86K
44970 15 13 $84K
71271 815 784 $81K
94726 2,144 1,985 $77K
73562 4,440 3,372 $76K
12002 369 344 $71K
72131 1,283 1,183 $70K
70486 1,570 1,472 $69K
94729 2,797 2,592 $69K
73030 5,046 4,293 $67K
J8597 Antiemetic drug, oral, not otherwise specified 10,190 8,643 $65K
80047 16,033 14,209 $65K
83880 6,974 6,083 $65K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 447 429 $62K
70360 1,157 1,129 $62K
58571 18 14 $61K
87641 4,287 3,926 $60K
J3490 Unclassified drugs 216,135 79,001 $58K
77334 376 270 $57K
P9047 Infusion, albumin (human), 25%, 50 ml 118 67 $55K
97804 581 526 $54K
84484 32,356 22,402 $54K
90715 2,885 2,681 $52K
73610 4,151 3,617 $50K
76775 500 472 $49K
77300 740 649 $49K
76882 475 436 $47K
73502 3,607 3,255 $47K
93325 1,419 1,298 $46K
72040 2,000 1,812 $45K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 731 655 $45K
83036 Hemoglobin; glycosylated (A1C) 10,844 9,857 $44K
77063 Screening digital breast tomosynthesis, bilateral 3,034 2,952 $41K
47562 14 13 $41K
72170 1,988 1,876 $41K
J0585 Injection, onabotulinumtoxina, 1 unit 472 240 $40K
85610 24,060 17,783 $40K
77470 58 54 $39K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 2,508 2,365 $39K
77072 622 609 $38K
97535 Self-care/home management training, each 15 minutes 1,390 808 $38K
88305 Level IV - Surgical pathology, gross and microscopic examination 13,826 9,917 $38K
96375 Therapeutic injection; each additional sequential IV push 34,042 25,655 $37K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 4,790 4,375 $37K
75561 102 95 $36K
72156 184 168 $36K
73700 368 339 $35K
82962 40,226 20,263 $35K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 5,024 4,399 $34K
36415 Collection of venous blood by venipuncture 38,705 27,492 $33K
77002 262 246 $33K
86850 13,068 11,706 $33K
87040 4,037 3,157 $33K
88307 2,035 1,624 $32K
73564 2,358 1,957 $32K
C1769 Guide wire 5,205 4,272 $32K
86923 1,434 1,020 $31K
73110 2,463 2,144 $30K
76604 960 898 $28K
93922 364 353 $28K
95819 145 132 $28K
77338 70 62 $27K
87510 3,150 2,895 $27K
76937 548 483 $27K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 89 86 $27K
72110 1,123 995 $26K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 17,031 11,105 $26K
58558 14 12 $24K
86900 13,632 12,210 $24K
76885 176 167 $24K
M0245 Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring 79 75 $23K
73560 1,814 1,498 $23K
77062 1,161 1,127 $23K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 28 26 $22K
72146 290 269 $22K
73590 2,333 1,980 $21K
86803 1,961 1,818 $20K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 125 121 $20K
85027 12,197 9,907 $20K
83605 12,706 10,573 $19K
72050 888 819 $19K
94660 94 48 $19K
76813 303 286 $19K
97022 589 248 $19K
88342 4,122 3,441 $19K
77061 751 682 $18K
95816 95 86 $18K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 1,091 978 $17K
27096 44 36 $17K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 11,805 10,071 $17K
73140 943 863 $17K
80076 3,991 3,394 $16K
82565 6,065 5,379 $16K
77295 12 12 $16K
96376 17,033 10,759 $16K
J2405 Injection, ondansetron hydrochloride, per 1 mg 49,784 40,220 $15K
73090 1,649 1,481 $15K
50435 12 12 $15K
64450 89 81 $15K
93351 40 39 $15K
94010 335 324 $15K
75574 58 56 $15K
96367 541 429 $14K
87660 3,150 2,895 $14K
90686 2,144 1,936 $14K
64415 40 39 $14K
J1650 Injection, enoxaparin sodium, 10 mg 12,957 5,328 $14K
A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml 1,586 1,481 $14K
64495 81 72 $13K
Q9957 Injection, perflutren lipid microspheres, per ml 1,982 1,813 $13K
81002 5,650 4,592 $13K
94667 99 84 $13K
86901 13,833 12,393 $13K
85379 2,496 2,302 $13K
73080 1,356 1,230 $13K
88341 2,439 1,728 $12K
J3010 Injection, fentanyl citrate, 0.1 mg 53,824 37,185 $12K
92611 222 205 $12K
74230 106 99 $12K
11721 1,320 1,040 $12K
73552 1,126 965 $11K
97760 219 205 $11K
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 2,803 2,354 $11K
J2704 Injection, propofol, 10 mg 42,099 34,147 $11K
81001 28,582 25,002 $11K
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 5,051 4,775 $11K
77080 182 176 $11K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 4,783 4,366 $10K
80061 Lipid panel 2,665 2,350 $10K
84443 Thyroid stimulating hormone (TSH) 5,175 4,679 $9K
J7120 Ringers lactate infusion, up to 1000 cc 32,964 26,207 $9K
64490 13 12 $9K
90732 479 443 $8K
84145 800 730 $8K
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 14 14 $8K
85014 16,961 14,841 $8K
83735 16,257 12,298 $8K
31575 62 55 $8K
99153 Mod sedat endo service >5yrs 2,550 2,244 $8K
72157 71 66 $8K
64447 43 38 $8K
82803 5,226 4,501 $8K
78499 57 57 $7K
J7050 Infusion, normal saline solution, 250 cc 24,095 13,389 $7K
87632 405 385 $7K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 866 778 $7K
J8499 Prescription drug, oral, non chemotherapeutic, nos 152,696 22,937 $7K
80179 1,214 1,134 $7K
94618 54 52 $7K
36600 570 498 $7K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 65 61 $7K
86140 9,741 8,580 $7K
93798 48 14 $7K
M0247 Intravenous infusion, sotrovimab, includes infusion and post administration monitoring 27 22 $7K
72070 428 400 $7K
74220 162 150 $7K
84703 11,261 10,137 $6K
87086 Culture, bacterial; quantitative colony count, urine 10,771 9,653 $6K
94727 202 191 $6K
78320 26 25 $6K
85730 7,230 6,454 $6K
99152 3,391 2,963 $6K
C9399 Unclassified drugs or biologicals 725 661 $6K
94644 2,662 2,381 $6K
81025 4,975 4,539 $6K
87522 Neg quan hep c or qual rna 267 241 $6K
82657 748 499 $6K
83690 19,986 16,995 $6K
77001 44 41 $6K
84702 4,254 3,669 $5K
77085 87 85 $5K
77290 14 12 $5K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 182 167 $5K
73100 297 237 $5K
J0690 Injection, cefazolin sodium, 500 mg 20,298 13,920 $5K
J1050 Injection, medroxyprogesterone acetate, 1 mg 247 225 $5K
72082 93 92 $5K
72128 138 132 $4K
76942 106 98 $4K
J2250 Injection, midazolam hydrochloride, per 1 mg 18,269 15,180 $4K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 30,109 26,836 $4K
43762 31 25 $4K
G0297 Low dose ct scan (ldct) for lung cancer screening 37 36 $4K
G0008 Administration of influenza virus vaccine 1,586 1,378 $4K
97035 137 50 $4K
G0379 Direct admission of patient for hospital observation care 12 12 $4K
93975 27 26 $4K
77301 13 12 $4K
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 219 172 $4K
87480 3,140 2,886 $4K
82728 1,429 1,240 $4K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 29,895 24,864 $4K
74300 15 13 $4K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 7,826 6,311 $4K
36416 8,939 5,107 $4K
81003 10,959 9,757 $3K
80143 1,388 1,281 $3K
86920 302 242 $3K
29125 96 93 $3K
74022 507 468 $3K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 1,497 1,372 $3K
0482T 205 180 $3K
74240 25 24 $3K
C1776 Joint device (implantable) 328 299 $3K
43760 13 12 $3K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 46 41 $3K
72072 112 103 $3K
12013 13 13 $3K
J1885 Injection, ketorolac tromethamine, per 15 mg 26,741 20,016 $3K
80074 403 377 $3K
87081 3,821 3,628 $3K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 3,553 3,397 $3K
74019 221 214 $3K
74178 14 12 $3K
87116 214 172 $3K
J7030 Infusion, normal saline solution , 1000 cc 16,170 12,335 $3K
73060 387 343 $2K
73070 219 198 $2K
17250 14 12 $2K
85652 6,879 6,094 $2K
72202 39 39 $2K
87186 4,817 4,150 $2K
88304 1,621 1,449 $2K
C1887 Catheter, guiding (may include infusion/perfusion capability) 1,607 1,281 $2K
87070 3,525 2,923 $2K
C1729 Catheter, drainage 485 427 $2K
87075 2,894 2,355 $2K
A4648 Tissue marker, implantable, any type, each 686 549 $2K
74241 12 12 $2K
87077 4,080 3,487 $2K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml 7,396 6,937 $2K
J0171 Injection, adrenalin, epinephrine, 0.1 mg 1,630 1,378 $2K
G0109 Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes 27 13 $2K
J7999 Compounded drug, not otherwise classified 3,261 2,432 $2K
84100 4,265 2,939 $2K
29515 12 12 $2K
J0330 Injection, succinylcholine chloride, up to 20 mg 7,054 5,853 $2K
87205 3,651 2,999 $2K
80164 265 222 $2K
J2785 Injection, regadenoson, 0.1 mg 2,157 1,987 $2K
96368 129 115 $2K
73120 144 120 $2K
J1610 Injection, glucagon hydrochloride, per 1 mg 26 24 $2K
00170 Anesthesia for intraoral procedures, including biopsy 960 875 $1K
83550 918 811 $1K
J8540 Dexamethasone, oral, 0.25 mg 324 195 $1K
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 1,764 1,191 $1K
J2270 Injection, morphine sulfate, up to 10 mg 11,969 8,900 $1K
84550 785 649 $1K
Q0247 Injection, sotrovimab, 500 mg 21 19 $1K
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 6,388 2,980 $1K
A9555 Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries 440 391 $1K
93926 12 12 $1K
97542 14 13 $1K
51798 1,124 913 $1K
J1815 Injection, insulin, per 5 units 4,860 2,309 $1K
85045 841 748 $1K
A9585 Injection, gadobutrol, 0.1 ml 2,456 2,263 $1K
J1170 Injection, hydromorphone, up to 4 mg 8,223 6,464 $1K
C1874 Stent, coated/covered, with delivery system 32 28 $1K
J1756 Injection, iron sucrose, 1 mg 187 102 $1K
94645 777 426 $1K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 1,761 1,633 $1K
82550 2,713 2,265 $1K
87015 2,802 2,033 $955.66
73200 13 13 $952.97
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 248 157 $935.52
93296 161 141 $905.08
99236 Prolong inpt eval add15 m 54 12 $894.62
83540 997 900 $885.11
97014 27 13 $881.72
82140 1,347 1,145 $835.89
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 2,556 2,011 $831.39
93976 30 25 $796.14
85018 664 463 $755.71
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 1,653 1,428 $739.52
82607 891 807 $739.45
83615 2,047 1,675 $738.89
J0696 Injection, ceftriaxone sodium, per 250 mg 7,402 5,535 $736.87
82570 1,728 1,465 $721.57
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 5,590 2,985 $718.04
J1644 Injection, heparin sodium, per 1000 units 9,193 3,633 $701.28
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 510 482 $678.68
J1200 Injection, diphenhydramine hcl, up to 50 mg 8,583 6,615 $667.57
89051 837 632 $647.91
90694 140 132 $641.37
J3370 Injection, vancomycin hcl, 500 mg 3,576 2,088 $636.79
A9577 Injection, gadobenate dimeglumine (multihance), per ml 1,368 1,253 $632.13
85046 361 329 $616.69
87088 1,430 1,298 $594.33
J3535 Drug administered through a metered dose inhaler 3,144 2,321 $534.83
73522 14 14 $524.27
J3475 Injection, magnesium sulfate, per 500 mg 3,515 2,740 $509.83
J1030 Injection, methylprednisolone acetate, 40 mg 2,429 2,250 $501.87
C1893 Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away 32 24 $495.60
A9270 Non-covered item or service 4,178 2,663 $494.59
82330 357 265 $492.44
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 1,871 1,728 $472.19
78434 252 237 $466.42
J0780 Injection, prochlorperazine, up to 10 mg 3,862 3,124 $458.46
90656 52 52 $443.41
J1790 Injection, droperidol, up to 5 mg 4,459 3,801 $441.23
J2370 Injection, phenylephrine hcl, up to 1 ml 4,307 3,427 $439.80
J2060 Injection, lorazepam, 2 mg 3,566 2,638 $397.37
J3480 Injection, potassium chloride, per 2 meq 2,941 1,950 $384.66
A6198 Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing 252 205 $368.50
J2795 Injection, ropivacaine hydrochloride, 1 mg 831 746 $366.84
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 4,237 3,365 $361.12
J2765 Injection, metoclopramide hcl, up to 10 mg 3,942 3,210 $359.28
82746 546 495 $356.84
93226 13 12 $355.85
88313 211 181 $338.40
84156 1,053 890 $327.68
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,397 1,144 $321.84
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 1,535 1,329 $320.91
88360 60 50 $278.88
90653 86 75 $266.69
0004A 13 12 $254.10
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 174 135 $249.72
G0257 Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility 28 14 $243.69
87340 664 580 $241.07
J1626 Injection, granisetron hydrochloride, 100 mcg 1,296 611 $237.70
J2550 Injection, promethazine hcl, up to 50 mg 2,232 1,692 $225.02
86706 530 470 $224.37
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 10,332 8,071 $221.77
S0028 Injection, famotidine, 20 mg 3,063 2,096 $220.32
84439 288 268 $216.31
J1940 Injection, furosemide, up to 20 mg 2,275 1,297 $211.89
S0164 Injection, pantoprazole sodium, 40 mg 2,206 1,240 $210.01
88112 27 24 $206.64
J2310 Injection, naloxone hydrochloride, per 1 mg 413 291 $186.05
88312 58 37 $176.16
J1040 Injection, methylprednisolone acetate, 80 mg 906 819 $164.12
89050 101 84 $162.61
43450 45 40 $151.29
L0120 Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar) 1,080 907 $145.29
J1580 Injection, garamycin, gentamicin, up to 80 mg 1,347 1,096 $137.09
51701 108 95 $120.47
90662 33 27 $118.30
87206 344 254 $117.62
86592 205 192 $114.26
Q0169 Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen 952 682 $111.49
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,647 1,417 $100.57
93225 14 12 $99.74
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 458 408 $99.16
J3360 Injection, diazepam, up to 5 mg 486 396 $98.45
80069 44 28 $97.48
G0009 Administration of pneumococcal vaccine 299 246 $96.25
64615 29 25 $96.24
J7042 5% dextrose/normal saline (500 ml = 1 unit) 763 546 $94.09
G0475 Hiv antigen/antibody, combination assay, screening 24 15 $93.71
82272 871 789 $91.47
J0360 Injection, hydralazine hcl, up to 20 mg 1,204 898 $90.18
J3372 Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mg 203 114 $85.53
J2919 Injection, methylprednisolone sodium succinate, 5 mg 368 293 $83.41
J3486 Injection, ziprasidone mesylate, 10 mg 16 13 $82.68
87807 188 180 $79.87
87071 124 113 $75.25
87102 230 180 $73.53
J3411 Injection, thiamine hcl, 100 mg 1,059 349 $73.22
87899 125 90 $71.21
82150 141 127 $70.41
80178 12 12 $68.72
80050 General health panel 89 85 $67.05
93356 42 40 $64.49
Q9963 High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml 2,341 2,074 $64.44
82784 53 48 $63.99
85384 162 145 $63.92
J2470 Injection, pantoprazole sodium, 40 mg 233 162 $63.70
87046 105 89 $62.59
J0136 Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg 29 13 $60.51
A6197 Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing 637 463 $51.48
J0692 Injection, cefepime hydrochloride, 500 mg 474 137 $47.51
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 1,990 1,346 $46.04
J1630 Injection, haloperidol, up to 5 mg 385 289 $45.63
87045 96 89 $44.61
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 1,612 470 $41.34
87449 88 70 $40.06
P9612 Catheterization for collection of specimen, single patient, all places of service 788 697 $40.02
S0077 Injection, clindamycin phosphate, 300 mg 1,324 782 $38.26
84132 145 127 $35.14
87147 106 95 $33.96
88302 32 24 $32.12
82010 163 147 $31.50
J1010 Injection, methylprednisolone acetate, 1 mg 225 220 $27.55
A6210 Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing 815 556 $24.47
J0737 Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg 123 90 $19.58
J7060 5% dextrose/water (500 ml = 1 unit) 324 170 $18.81
88311 13 13 $17.41
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 17 17 $14.97
93321 320 305 $11.81
J1836 Injection, metronidazole, 10 mg 562 324 $8.48
94761 310 194 $7.69
J2003 Injection, lidocaine hydrochloride, 1 mg 1,000 869 $6.82
85347 25 24 $5.67
82945 29 26 $5.51
C9113 Injection, pantoprazole sodium, per vial 62 30 $5.24
86308 77 74 $4.66
J1920 Injection, labetalol hydrochloride, 5 mg 151 118 $4.07
J1596 Injection, glycopyrrolate, 0.1 mg 182 164 $2.97
84157 72 65 $2.85
S0030 Injection, metronidazole, 500 mg 1,019 618 $2.27
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 623 425 $0.01
A4649 Surgical supply; miscellaneous 2,123 1,508 $0.00
A6196 Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing 41 27 $0.00
87324 32 28 $0.00
G8985 Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 57 39 $0.00
51702 45 40 $0.00
99157 34 27 $0.00
J1953 Injection, levetiracetam, 10 mg 377 269 $0.00
22853 28 26 $0.00
C1760 Closure device, vascular (implantable/insertable) 118 99 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 540 380 $0.00
A6021 Collagen dressing, sterile, size 16 sq. in. or less, each 671 465 $0.00
20930 67 53 $0.00
Q9961 High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml 68 62 $0.00
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 132 122 $0.00
A9526 Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries 91 40 $0.00
J0736 Injection, clindamycin phosphate, 300 mg 60 44 $0.00
J3260 Injection, tobramycin sulfate, up to 80 mg 23 13 $0.00
C1758 Catheter, ureteral 31 26 $0.00
M0222 Intravenous injection, bebtelovimab, includes injection and post administration monitoring 34 30 $0.00
J9370 Vincristine sulfate, 1 mg 57 24 $0.00
70250 13 12 $0.00
J2359 Injection, olanzapine, 0.5 mg 34 27 $0.00
J1171 Injection, hydromorphone, 0.1 mg 158 125 $0.00
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 209 137 $0.00
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 160 113 $0.00
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 175 120 $0.00
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 158 74 $0.00
J2358 Injection, olanzapine, long-acting, 1 mg 227 135 $0.00
A9503 Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries 107 103 $0.00
99156 206 182 $0.00
C1781 Mesh (implantable) 127 118 $0.00
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals 171 118 $0.00
G8982 Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 14 12 $0.00
96409 85 51 $0.00
J3590 Unclassified biologics 68 57 $0.00
J9045 Injection, carboplatin, 50 mg 25 12 $0.00
J2305 Injection, nitroglycerin, 5 mg 12 12 $0.00
G0269 Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) 12 12 $0.00
88300 13 12 $0.00