Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OH › PORTSMOUTH › SOUTHERN OHIO MEDICAL CENTER

SOUTHERN OHIO MEDICAL CENTER

NPI: 1053342816 · PORTSMOUTH, OH 45662 · Clinical Medical Laboratory · NPI assigned 07/06/2006

$145.26M
Total Medicaid Paid
3,493,646
Total Claims
2,845,092
Beneficiaries
648
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialWRAY, DEAN (VICE PRESIDENT OF FINANCE)
NPI Enumeration Date07/06/2006

Related Entities

Other providers sharing the same authorized official: WRAY, DEAN

ProviderCityStateTotal Paid
SOUTHERN OHIO MEDICAL CENTER PORTSMOUTH OH $10.54M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 321,214 $11.02M
2019 358,027 $12.50M
2020 284,627 $13.49M
2021 368,475 $17.88M
2022 484,790 $22.36M
2023 908,986 $36.33M
2024 767,527 $31.68M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G0463 Hospital outpatient clinic visit for assessment and management of a patient 387,130 304,809 $38.84M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 189,285 173,395 $17.78M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 136,656 126,832 $14.95M
99284 Emergency department visit for the evaluation and management, high severity 48,606 42,292 $6.03M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 30,180 26,031 $4.03M
99283 Emergency department visit for the evaluation and management, moderate severity 23,316 21,801 $2.58M
70450 Computed tomography, head or brain; without contrast material 9,954 8,636 $2.47M
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 66,921 59,390 $2.24M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 25,734 24,102 $2.17M
74177 Computed tomography, abdomen and pelvis; with contrast material 6,305 5,438 $2.11M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 36,231 7,917 $2.07M
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 64,485 57,294 $1.86M
96361 Intravenous infusion, hydration; each additional hour 8,877 5,739 $1.79M
74176 Computed tomography, abdomen and pelvis; without contrast material 4,503 3,943 $1.51M
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 56,291 48,295 $1.44M
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 11,348 10,774 $1.32M
80053 Comprehensive metabolic panel 74,429 64,417 $1.28M
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 11,235 4,671 $1.10M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 3,089 2,743 $1.01M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3,941 3,480 $927K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 4,433 2,014 $908K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 11,150 5,167 $882K
20610 7,571 6,297 $872K
G0378 Hospital observation service, per hour 9,466 3,762 $870K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 38,257 31,844 $844K
0223U 4,337 4,151 $843K
93458 717 605 $839K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 11,391 10,397 $797K
84443 Thyroid stimulating hormone (TSH) 58,987 54,780 $774K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 6,714 5,790 $670K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 7,641 7,033 $624K
95810 Polysomnography; sleep staging with 4 or more additional parameters 913 880 $588K
80048 Basic metabolic panel (calcium, ionized) 85,126 70,409 $587K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 35,631 33,332 $584K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 73,896 59,744 $578K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 136,577 114,285 $578K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,467 1,100 $558K
36415 Collection of venous blood by venipuncture 248,555 177,252 $549K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 18,113 4,590 $519K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 5,081 3,355 $468K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 56,310 51,915 $448K
71046 Radiologic examination, chest; 2 views 19,201 16,809 $437K
J0585 Injection, onabotulinumtoxina, 1 unit 886 528 $421K
80061 Lipid panel 39,669 36,243 $402K
71275 Computed tomographic angiography, chest, with contrast material 1,320 1,133 $399K
76705 Ultrasound, abdominal, real time with image documentation; limited 3,962 3,414 $388K
45380 Colonoscopy, flexible; with biopsy, single or multiple 1,068 935 $376K
59025 Fetal non-stress test 2,371 1,160 $373K
99281 Emergency department visit for the evaluation and management, self-limited or minor 2,993 2,696 $367K
82607 22,837 21,266 $359K
83036 Hemoglobin; glycosylated (A1C) 35,412 33,191 $350K
95886 1,665 1,078 $343K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 5,430 1,845 $343K
76830 Ultrasound, transvaginal 3,453 3,203 $333K
90839 2,506 2,061 $316K
99282 Emergency department visit for the evaluation and management, low to moderate severity 3,011 2,813 $291K
71045 Radiologic examination, chest; single view 32,477 27,513 $272K
99215 Prolong outpt/office vis 2,877 2,501 $271K
93975 1,650 1,400 $242K
95811 381 347 $240K
97530 Therapeutic activities, direct patient contact, each 15 minutes 5,070 2,587 $235K
11045 691 260 $232K
G0483 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; 22 or more drug class(es), including metabolite(s) if performed 3,374 2,601 $230K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 1,337 864 $228K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 28,447 20,676 $211K
96375 Therapeutic injection; each additional sequential IV push 18,686 13,332 $207K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 14,364 13,258 $202K
78431 371 281 $202K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 1,634 1,566 $201K
84439 21,152 19,618 $201K
71271 1,237 1,172 $201K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 14,164 13,110 $189K
87086 Culture, bacterial; quantitative colony count, urine 36,608 32,588 $182K
71250 1,637 1,473 $181K
75574 589 509 $179K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 658 596 $174K
97161 2,586 2,403 $173K
93017 2,142 1,928 $170K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 173 154 $167K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 10,362 6,454 $167K
72125 Computed tomography, cervical spine; without contrast material 3,067 2,680 $161K
78815 Positron emission tomography (PET) for limited area imaging 340 297 $161K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 811 746 $159K
J3490 Unclassified drugs 15,052 8,875 $159K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 325 269 $157K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 15,210 12,641 $154K
83605 31,390 25,021 $150K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 1,580 809 $150K
J7030 Infusion, normal saline solution , 1000 cc 49,151 35,389 $147K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 547 481 $145K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 22,374 17,231 $142K
71260 Computed tomography, thorax, diagnostic; with contrast material 884 727 $138K
80076 36,703 31,971 $136K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 3,556 1,009 $133K
84484 28,710 21,867 $127K
J0561 Injection, penicillin g benzathine, 100,000 units 670 589 $124K
76536 1,177 1,093 $122K
64615 512 396 $122K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 21,273 18,031 $122K
76641 1,227 824 $116K
C1776 Joint device (implantable) 147 120 $115K
72131 1,344 1,152 $115K
70551 Magnetic resonance imaging, brain; without contrast material 542 488 $115K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 1,425 1,174 $110K
94060 1,190 1,103 $107K
87481 8,796 5,525 $105K
73221 408 372 $105K
81003 51,994 41,788 $105K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 10,244 9,513 $104K
87522 Neg quan hep c or qual rna 3,763 3,395 $104K
73630 4,912 4,028 $103K
84145 14,275 12,445 $100K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 5,280 4,472 $91K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 205 154 $91K
87625 5,029 4,759 $91K
12001 591 541 $91K
93970 673 587 $90K
87653 5,232 4,818 $89K
74178 257 229 $88K
83540 11,857 10,885 $88K
87902 637 589 $86K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 9,451 8,997 $83K
80074 5,098 4,585 $83K
84702 5,692 3,985 $83K
31575 508 482 $82K
82728 6,749 5,965 $81K
73030 3,482 2,816 $81K
58558 91 72 $81K
87040 18,536 10,145 $79K
87081 7,116 6,503 $78K
73562 3,320 2,571 $76K
81596 668 628 $75K
83735 25,047 19,605 $75K
96376 4,605 2,210 $75K
97162 1,422 1,223 $73K
97016 2,280 583 $73K
93971 1,037 911 $73K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,090 1,043 $73K
77063 Screening digital breast tomosynthesis, bilateral 1,664 1,517 $72K
47562 30 26 $71K
52000 120 108 $71K
84703 15,688 13,907 $69K
95816 483 436 $69K
73610 3,115 2,595 $69K
81025 8,347 7,649 $68K
93356 341 299 $65K
87529 4,824 3,353 $65K
87511 5,976 5,500 $64K
94726 1,098 1,035 $63K
96367 1,512 965 $63K
73130 3,037 2,404 $62K
20550 470 385 $62K
93880 689 625 $61K
97165 882 767 $60K
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants 209 205 $60K
92928 16 13 $58K
93226 532 506 $57K
83525 3,547 3,262 $57K
72100 1,661 1,504 $56K
84481 5,122 4,734 $55K
83550 7,861 7,248 $54K
82746 5,184 4,866 $53K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 3,010 2,698 $53K
86140 12,322 10,701 $52K
83880 7,753 6,407 $52K
J1885 Injection, ketorolac tromethamine, per 15 mg 18,672 11,613 $51K
86592 2,830 2,429 $51K
85007 11,637 9,555 $51K
95913 445 406 $51K
72141 320 291 $50K
G0482 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; 15-21 drug class(es), including metabolite(s) if performed 697 556 $49K
81001 41,079 36,235 $48K
73560 2,398 1,747 $48K
70491 158 140 $48K
J2405 Injection, ondansetron hydrochloride, per 1 mg 20,219 15,045 $48K
84144 1,987 1,699 $48K
C1769 Guide wire 1,118 910 $47K
86695 2,914 2,711 $47K
93798 1,655 275 $47K
94729 1,137 1,072 $46K
93225 564 521 $45K
80081 2,169 2,024 $45K
94618 609 555 $45K
83655 3,263 3,064 $44K
G0481 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; 8-14 drug class(es), including metabolite(s) if performed 618 593 $43K
84403 2,829 2,554 $43K
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 224 190 $43K
85027 12,711 10,574 $43K
85610 18,221 14,611 $42K
86696 2,989 2,712 $42K
73110 2,132 1,686 $41K
76775 544 494 $41K
86481 819 691 $40K
73502 1,877 1,518 $40K
97116 1,532 563 $39K
J3010 Injection, fentanyl citrate, 0.1 mg 13,488 10,618 $39K
73700 308 265 $38K
70486 533 457 $37K
58661 22 13 $37K
J2704 Injection, propofol, 10 mg 12,717 9,659 $37K
87186 6,871 5,965 $36K
82950 3,327 3,103 $36K
97113 602 183 $36K
77067 Screening mammography, bilateral, including computer-aided detection 1,575 1,476 $36K
91200 467 447 $35K
72128 634 547 $34K
92557 508 449 $34K
74018 2,060 1,792 $33K
82670 1,715 1,547 $33K
J1756 Injection, iron sucrose, 1 mg 1,009 379 $33K
11981 159 142 $32K
95912 261 244 $32K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 8,963 6,862 $32K
90715 1,805 1,618 $31K
83690 21,331 18,610 $31K
76981 508 474 $30K
J2250 Injection, midazolam hydrochloride, per 1 mg 12,879 10,065 $30K
95911 311 284 $29K
90686 1,963 1,781 $29K
20552 358 343 $29K
G0297 Low dose ct scan (ldct) for lung cancer screening 199 192 $29K
76857 223 194 $28K
72040 730 655 $28K
P9016 Red blood cells, leukocytes reduced, each unit 161 110 $28K
84146 2,180 1,961 $28K
76819 Fetal biophysical profile; without non-stress testing 278 151 $28K
A9555 Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries 389 304 $28K
72070 831 757 $27K
J1050 Injection, medroxyprogesterone acetate, 1 mg 581 508 $27K
74019 1,172 1,067 $27K
84402 1,960 1,787 $27K
C1753 Catheter, intravascular ultrasound 336 282 $26K
72110 677 598 $26K
86850 1,365 1,092 $26K
83001 1,832 1,652 $26K
C1887 Catheter, guiding (may include infusion/perfusion capability) 724 619 $26K
36430 244 158 $25K
86038 1,430 1,230 $25K
82962 13,448 7,615 $25K
70496 115 97 $25K
96127 676 624 $24K
84153 1,839 1,697 $24K
10060 148 134 $24K
86900 2,053 1,485 $24K
77062 763 659 $23K
86376 1,597 1,477 $23K
88305 Level IV - Surgical pathology, gross and microscopic examination 2,307 1,406 $22K
77080 336 294 $22K
87109 1,939 1,857 $22K
87641 1,398 1,222 $22K
87631 189 175 $21K
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 1,361 1,161 $21K
36416 8,941 6,677 $21K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 315 307 $21K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 110 104 $21K
C1751 Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) 1,520 1,249 $21K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 14 12 $21K
74022 1,006 902 $20K
73564 838 701 $20K
86803 1,427 1,328 $20K
92978 263 223 $20K
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 419 221 $20K
85652 6,785 5,913 $19K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,831 2,478 $19K
83970 852 758 $19K
84681 1,603 1,505 $19K
64493 44 39 $19K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 1,161 1,026 $19K
82626 995 898 $18K
J7120 Ringers lactate infusion, up to 1000 cc 6,829 4,842 $18K
70498 168 142 $18K
J0690 Injection, cefazolin sodium, 500 mg 5,027 2,974 $18K
72050 320 289 $18K
73080 922 775 $18K
83002 1,398 1,258 $18K
96368 472 328 $18K
85730 10,428 8,922 $18K
82043 3,263 3,037 $18K
11102 40 40 $18K
93922 258 244 $18K
31231 107 104 $17K
86800 1,467 1,337 $17K
87340 1,177 1,106 $17K
58563 17 12 $17K
82248 1,887 1,605 $17K
84207 1,346 1,242 $17K
87506 152 140 $16K
J1170 Injection, hydromorphone, up to 4 mg 3,716 1,934 $16K
C1874 Stent, coated/covered, with delivery system 237 200 $16K
C9290 Injection, bupivacaine liposome, 1 mg 110 94 $16K
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 16 13 $16K
76010 935 831 $15K
69210 1,066 986 $15K
73523 429 377 $15K
86787 823 746 $15K
86694 588 531 $15K
82077 6,133 5,116 $14K
88142 1,144 1,113 $14K
87070 3,523 3,237 $14K
20605 104 88 $14K
J2270 Injection, morphine sulfate, up to 10 mg 4,269 2,659 $14K
12002 100 95 $14K
76882 130 121 $14K
19081 18 16 $13K
73590 981 792 $13K
17110 91 89 $13K
86706 1,086 1,017 $13K
77061 418 363 $13K
77066 Tomosynthesis, mammo 733 653 $13K
83498 923 838 $13K
76870 342 288 $13K
85018 6,965 6,145 $13K
58300 88 79 $13K
73090 786 672 $12K
J1644 Injection, heparin sodium, per 1000 units 4,685 2,402 $12K
84100 5,224 3,915 $12K
11982 57 56 $12K
82533 581 477 $12K
J0696 Injection, ceftriaxone sodium, per 250 mg 4,077 2,794 $12K
87071 1,829 1,461 $12K
82947 2,858 2,310 $12K
82565 1,956 1,584 $11K
64721 15 13 $11K
72170 978 792 $11K
82552 2,002 1,633 $11K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 62 57 $11K
92567 747 689 $10K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 2,665 2,200 $10K
70544 87 69 $10K
86431 874 747 $10K
72114 244 225 $10K
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 1,310 913 $10K
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 686 580 $10K
J2785 Injection, regadenoson, 0.1 mg 1,339 1,180 $10K
97010 771 161 $9K
86704 508 477 $9K
62323 12 12 $9K
70480 85 61 $9K
84436 1,038 972 $9K
93299 691 665 $9K
83883 345 304 $9K
85379 3,329 2,836 $9K
76642 110 95 $9K
36600 1,903 1,420 $9K
76000 185 150 $8K
82140 1,698 1,371 $8K
82570 1,292 1,098 $8K
84480 753 678 $8K
77065 Tomosynthesis, mammo 424 384 $8K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 16 12 $8K
73140 467 400 $8K
86901 2,024 1,493 $8K
84550 1,872 1,595 $8K
52204 17 13 $7K
73620 410 357 $7K
76770 44 41 $7K
82150 3,503 3,032 $7K
80143 3,826 3,261 $7K
43450 454 365 $7K
82951 343 308 $7K
77336 113 48 $7K
95012 190 177 $7K
90677 69 67 $6K
84112 217 190 $6K
86200 550 483 $6K
87807 2,675 2,379 $6K
84425 608 566 $6K
80164 424 382 $6K
71101 476 416 $6K
82977 972 771 $6K
74420 84 77 $6K
J0558 Injection, penicillin g benzathine and penicillin g procaine, 100,000 units 58 49 $6K
83516 388 145 $6K
36591 1,072 396 $6K
97164 183 159 $6K
82784 664 585 $6K
80179 3,813 3,265 $6K
82105 557 507 $6K
87205 2,410 2,110 $5K
80051 436 369 $5K
82803 1,893 1,443 $5K
J1200 Injection, diphenhydramine hcl, up to 50 mg 2,329 1,686 $5K
73060 361 296 $5K
73552 342 288 $5K
93571 195 159 $5K
93321 31 25 $5K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 800 697 $5K
86364 328 306 $5K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 154 136 $5K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 11,647 7,043 $5K
J7050 Infusion, normal saline solution, 250 cc 2,800 1,319 $5K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,138 840 $5K
90656 357 352 $5K
83519 167 137 $5K
87184 471 398 $5K
J3370 Injection, vancomycin hcl, 500 mg 1,106 541 $5K
86255 408 364 $4K
93288 379 366 $4K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 311 271 $4K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 732 405 $4K
80361 507 484 $4K
58301 51 41 $4K
99406 137 122 $4K
84479 586 558 $4K
82952 340 305 $4K
J3475 Injection, magnesium sulfate, per 500 mg 1,587 1,122 $4K
87077 1,557 1,378 $4K
70470 16 14 $4K
97597 87 54 $4K
72020 611 522 $4K
82103 303 262 $4K
85520 2,078 1,587 $4K
82310 719 624 $4K
J2791 Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu 56 51 $4K
90460 Immunization administration through 18 years of age via any route, first or only component 2,804 2,555 $4K
83010 554 496 $4K
84156 894 601 $4K
83615 1,147 951 $4K
73120 188 159 $4K
29125 289 249 $4K
J2919 Injection, methylprednisolone sodium succinate, 5 mg 666 472 $4K
82172 359 318 $3K
57454 12 12 $3K
J8501 Aprepitant, oral, 5 mg 260 215 $3K
82330 1,634 1,267 $3K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 64 60 $3K
J2800 Injection, methocarbamol, up to 10 ml 433 331 $3K
P9047 Infusion, albumin (human), 25%, 50 ml 24 15 $3K
83721 495 450 $3K
82375 1,542 1,224 $3K
84520 891 771 $3K
77002 43 37 $3K
84132 1,845 1,465 $3K
86003 174 101 $3K
86618 340 303 $3K
86617 362 225 $3K
93325 45 38 $3K
84460 630 499 $3K
80354 505 483 $3K
80348 507 484 $3K
A9575 Injection, gadoterate meglumine, 0.1 ml 1,333 1,029 $3K
J2060 Injection, lorazepam, 2 mg 1,344 899 $3K
87493 201 179 $3K
80346 440 423 $3K
83921 461 432 $3K
84450 515 395 $3K
J2765 Injection, metoclopramide hcl, up to 10 mg 1,122 791 $3K
J1650 Injection, enoxaparin sodium, 10 mg 873 388 $3K
90837 Psychotherapy, 53 minutes with patient 13 12 $3K
85014 521 394 $3K
80353 508 485 $3K
80365 491 469 $3K
80358 508 484 $3K
83992 197 183 $3K
82024 74 64 $2K
87210 837 745 $2K
86308 643 575 $2K
73600 167 138 $2K
86923 119 83 $2K
80326 211 197 $2K
64483 18 17 $2K
80321 310 301 $2K
J1030 Injection, methylprednisolone acetate, 40 mg 230 180 $2K
Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml 303 265 $2K
82550 201 198 $2K
86665 222 131 $2K
82247 377 218 $2K
J1010 Injection, methylprednisolone acetate, 1 mg 210 180 $2K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 1,372 1,083 $2K
97163 32 32 $2K
84295 1,303 1,021 $2K
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 153 144 $2K
80355 219 204 $2K
86235 132 112 $2K
80178 159 136 $2K
86141 87 75 $2K
C1781 Mesh (implantable) 15 14 $2K
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 1,220 979 $2K
90461 2,326 2,116 $2K
88184 16 12 $2K
84445 67 60 $2K
97535 Self-care/home management training, each 15 minutes 66 38 $2K
83050 1,506 1,194 $2K
86015 132 115 $2K
93799 47 44 $2K
80377 195 182 $2K
80360 197 183 $2K
80337 197 183 $2K
80334 197 183 $2K
80338 197 183 $2K
80331 197 183 $2K
J2795 Injection, ropivacaine hydrochloride, 1 mg 503 418 $2K
80373 197 183 $2K
84305 95 90 $2K
80341 197 183 $2K
80370 197 183 $2K
80344 197 183 $2K
73100 86 70 $2K
80366 197 183 $2K
80368 197 183 $2K
80372 197 183 $2K
80367 197 183 $2K
80357 197 183 $2K
80364 197 183 $2K
80359 197 183 $2K
80371 197 183 $2K
90694 191 168 $2K
86225 158 147 $2K
12011 12 12 $1K
87581 272 270 $1K
82040 334 279 $1K
86664 149 131 $1K
82652 137 120 $1K
97166 13 12 $1K
82465 308 274 $1K
J2598 Injection, vasopressin, 1 unit 107 63 $1K
51798 575 527 $1K
J2370 Injection, phenylephrine hcl, up to 1 ml 534 415 $1K
80362 295 286 $1K
82785 138 127 $1K
73070 66 55 $1K
83521 334 224 $1K
J3480 Injection, potassium chloride, per 2 meq 581 370 $1K
80349 296 287 $1K
92523 14 14 $1K
80356 294 285 $1K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 124 112 $1K
80324 279 270 $1K
82272 176 164 $1K
76377 48 46 $1K
87045 87 77 $1K
J2470 Injection, pantoprazole sodium, 40 mg 179 111 $1K
87177 82 71 $1K
J1953 Injection, levetiracetam, 10 mg 175 124 $1K
20553 33 26 $1K
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 261 139 $1K
72220 26 26 $972.43
93925 13 13 $942.03
90674 38 35 $921.16
81420 Fetal chromosomal aneuploidy genomic sequence analysis panel 15 14 $902.86
88185 15 12 $872.24
85045 413 372 $872.02
A4217 Sterile water/saline, 500 ml 979 904 $860.33
J0171 Injection, adrenalin, epinephrine, 0.1 mg 441 313 $849.59
99195 24 13 $819.44
86160 84 72 $818.61
J1940 Injection, furosemide, up to 20 mg 556 298 $814.82
29581 26 15 $796.27
84482 96 95 $781.10
J0360 Injection, hydralazine hcl, up to 20 mg 291 194 $773.14
80069 81 60 $745.67
84478 281 237 $745.42
73000 47 41 $727.16
J7121 5% dextrose in lactated ringers infusion, up to 1000 cc 189 127 $725.14
72081 13 13 $721.37
72052 16 14 $703.19
90653 113 113 $701.23
C1760 Closure device, vascular (implantable/insertable) 85 67 $675.45
G0103 Prostate cancer screening; prostate specific antigen test (psa) 572 387 $661.53
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 35 16 $648.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 1,144 488 $641.05
11721 58 54 $623.53
J1580 Injection, garamycin, gentamicin, up to 80 mg 454 362 $611.75
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 125 56 $598.37
84165 175 157 $572.08
80177 46 41 $567.91
87185 211 179 $552.55
88304 34 28 $530.25
J0574 Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine 60 24 $529.63
86705 42 33 $499.74
95249 156 141 $474.25
80347 67 60 $419.82
J1171 Injection, hydromorphone, 0.1 mg 262 132 $413.99
J1630 Injection, haloperidol, up to 5 mg 540 411 $411.71
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 304 213 $396.10
J2372 Injection, phenylephrine hydrochloride (biorphen), 20 micrograms 1,568 693 $390.12
90678 21 14 $389.86
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 888 721 $386.63
J1836 Injection, metronidazole, 10 mg 101 43 $377.11
J1941 Injection, furosemide (furoscix), 20 mg 64 24 $354.77
80299 24 24 $354.72
86304 17 14 $350.39
84155 179 161 $349.44
90472 Immunization administration, each additional vaccine (list separately) 66 62 $333.68
83993 14 12 $329.78
86708 87 87 $293.99
86709 27 27 $293.83
86334 27 24 $292.37
82378 31 25 $277.96
86666 57 44 $251.11
90661 19 19 $243.36
87149 58 53 $233.50
84154 25 25 $233.19
87523 14 13 $219.69
86039 16 13 $217.53
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 135 131 $216.17
J3535 Drug administered through a metered dose inhaler 216 199 $210.25
82010 141 125 $184.17
80156 13 12 $182.10
82274 16 15 $171.34
86753 39 37 $164.48
90662 47 42 $160.53
86008 25 25 $160.07
J8499 Prescription drug, oral, non chemotherapeutic, nos 129 117 $160.06
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 14 13 $159.76
85347 195 157 $139.54
64494 44 39 $138.00
J2003 Injection, lidocaine hydrochloride, 1 mg 698 494 $124.19
87075 33 27 $112.52
90682 17 13 $109.86
87430 83 83 $109.33
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 29 13 $108.88
87338 15 13 $92.52
84238 13 12 $78.90
J0173 Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg 19 15 $74.58
88720 58 54 $60.32
G0009 Administration of pneumococcal vaccine 33 30 $58.27
G0008 Administration of influenza virus vaccine 97 93 $55.92
J2010 Injection, lincomycin hcl, up to 300 mg 14 13 $50.38
J2310 Injection, naloxone hydrochloride, per 1 mg 18 13 $50.11
J1956 Injection, levofloxacin, 250 mg 224 192 $48.46
J2360 Injection, orphenadrine citrate, up to 60 mg 13 13 $47.60
J0692 Injection, cefepime hydrochloride, 500 mg 42 28 $32.91
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 124 43 $32.60
89055 15 13 $27.41
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 152 109 $23.66
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 219 129 $23.03
J1790 Injection, droperidol, up to 5 mg 37 33 $21.70
G0476 Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test 47 36 $20.21
Q3014 Telehealth originating site facility fee 15 15 $12.48
J0136 Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg 24 15 $5.00
87102 13 12 $0.00
00840 165 158 $0.00
00170 Anesthesia for intraoral procedures, including biopsy 17 15 $0.00
87101 15 12 $0.00
99152 12 12 $0.00
88112 13 12 $0.00
A9270 Non-covered item or service 477 399 $0.00
94010 14 14 $0.00
87206 27 24 $0.00
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 17 13 $0.00
91307 12 12 $0.00
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 29 27 $0.00
1126F 61 55 $0.00
88342 45 44 $0.00
87015 27 24 $0.00
87116 27 24 $0.00
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 42 12 $0.00