Medicaid Provider Spending

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

JOHNSTON MEMORIAL HOSPITAL, INC

NPI: 1104812684 · ABINGDON, VA 24211 · Psychiatric Hospital Unit · NPI assigned 09/21/2005

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

Authorized official HILTON, SHANE controls 20+ related entities in our dataset. Read more

$35.91M
Total Medicaid Paid
991,907
Total Claims
791,528
Beneficiaries
365
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialHILTON, SHANE (EVP/CFO)
NPI Enumeration Date09/21/2005

Related Entities

Other providers sharing the same authorized official: HILTON, SHANE

ProviderCityStateTotal Paid
WELLMONT HEALTH SYSTEM BIG STONE GAP VA $33.71M
MOUNTAIN STATES HEALTH ALLIANCE JOHNSON CITY TN $31.31M
WELLMONT MEDICAL ASSOCIATES INC KINGSPORT TN $27.84M
WELLMONT HEALTH SYSTEM BRISTOL TN $27.35M
TAKOMA REGIONAL HOSPITAL INC GREENEVILLE TN $20.22M
WELLMONT HEALTH SYSTEM KINGSPORT TN $17.64M
MOUNTAIN STATES HEALTH ALLIANCE KINGSPORT TN $15.47M
SMYTH COUNTY COMMUNITY HOSPITAL MARION VA $15.33M
MOUNTAIN STATES HEALTH ALLIANCE LEBANON VA $11.37M
MOUNTAIN STATES HEALTH ALLIANCE PENNINGTON GAP VA $8.28M
MOUNTAIN STATES HEALTH ALLIANCE JOHNSON CITY TN $8.14M
MOUNTAIN STATES HEALTH ALLIANCE ELIZABETHTON TN $7.25M
DICKENSON COMMUNITY HOSPITAL, INC. CLINTWOOD VA $6.94M
WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC ROGERSVILLE TN $5.11M
EAST TENNESSEE HEALTHCARE HOLDINGS INC GRAY TN $3.30M
MOUNTAIN STATES HEALTH ALLIANCE MOUNTAIN CITY TN $3.03M
WELLMONT HEALTH SYSTEM SNEEDVILLE TN $1.90M
MOUNTAIN STATES HEALTH ALLIANCE ERWIN TN $1.48M
WILSON PHARMACY INC JOHNSON CITY TN $1.26M
MOUNTAIN STATES HEALTH ALLIANCE NORTON VA $376K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 135,988 $3.14M
2019 174,612 $5.00M
2020 135,214 $4.76M
2021 134,503 $4.72M
2022 137,403 $5.64M
2023 159,677 $7.02M
2024 114,510 $5.64M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 27,169 23,541 $3.73M
96361 Intravenous infusion, hydration; each additional hour 12,513 9,318 $2.52M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 20,610 17,616 $2.31M
99283 Emergency department visit for the evaluation and management, moderate severity 17,745 15,695 $2.07M
41899 Unlisted procedure, dentoalveolar structures 2,077 1,991 $1.94M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 19,155 15,033 $1.48M
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 1,153 1,108 $1.30M
74177 Computed tomography, abdomen and pelvis; with contrast material 7,170 6,444 $1.27M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3,305 3,028 $866K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 18,731 4,695 $856K
70450 Computed tomography, head or brain; without contrast material 5,413 4,703 $806K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,897 1,737 $668K
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 1,061 549 $653K
42820 Tonsillectomy and adenoidectomy; younger than age 12 429 401 $651K
36415 Collection of venous blood by venipuncture 37,043 26,445 $649K
99282 Emergency department visit for the evaluation and management, low to moderate severity 4,554 4,173 $586K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,980 4,337 $576K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 8,978 7,813 $547K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 952 873 $540K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 5,676 1,709 $496K
78815 Positron emission tomography (PET) for limited area imaging 813 695 $458K
74176 Computed tomography, abdomen and pelvis; without contrast material 2,661 2,369 $457K
G0378 Hospital observation service, per hour 4,269 3,579 $451K
80053 Comprehensive metabolic panel 59,771 47,539 $443K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 7,831 6,982 $400K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 795 750 $392K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 5,110 3,895 $366K
97530 Therapeutic activities, direct patient contact, each 15 minutes 8,705 2,355 $355K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 2,388 1,725 $344K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 3,665 2,930 $325K
71275 Computed tomographic angiography, chest, with contrast material 1,714 1,566 $316K
45380 Colonoscopy, flexible; with biopsy, single or multiple 767 690 $275K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,666 1,536 $264K
43235 749 695 $264K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 2,889 1,356 $254K
81001 22,646 19,074 $241K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 11,831 10,508 $234K
76705 Ultrasound, abdominal, real time with image documentation; limited 2,666 2,486 $231K
95811 416 396 $230K
J3490 Unclassified drugs 8,426 5,101 $224K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 773 715 $143K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 3,797 2,591 $140K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 835 745 $138K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 340 328 $135K
95810 Polysomnography; sleep staging with 4 or more additional parameters 236 216 $130K
77067 Screening mammography, bilateral, including computer-aided detection 2,916 2,821 $117K
83036 Hemoglobin; glycosylated (A1C) 14,858 13,838 $106K
93971 1,462 1,293 $105K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 388 353 $104K
71046 Radiologic examination, chest; 2 views 8,746 7,771 $101K
93017 1,146 1,063 $98K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 5,460 1,525 $96K
76700 Ultrasound, abdominal, real time with image documentation; complete 790 751 $96K
J7050 Infusion, normal saline solution, 250 cc 586 227 $92K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 65,501 50,660 $91K
C1889 Implantable/insertable device, not otherwise classified 760 736 $88K
0202U Oncology (prostate), multianalyte, gene expression profiling 648 611 $86K
84443 Thyroid stimulating hormone (TSH) 16,999 15,365 $84K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 715 632 $80K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,309 1,191 $80K
97162 1,062 958 $73K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 5,459 5,090 $71K
70551 Magnetic resonance imaging, brain; without contrast material 396 368 $71K
80048 Basic metabolic panel (calcium, ionized) 11,201 8,966 $69K
76536 653 626 $66K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 4,404 4,140 $62K
A9585 Injection, gadobutrol, 0.1 ml 1,587 1,454 $62K
83880 4,417 3,780 $62K
74018 2,444 2,103 $61K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 586 548 $60K
29581 390 131 $60K
97597 871 524 $58K
72141 307 289 $54K
81025 6,386 5,698 $52K
64493 85 81 $48K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 4,398 4,136 $47K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 24,558 18,099 $46K
87040 6,980 3,614 $43K
73221 246 230 $39K
71250 704 637 $39K
80061 Lipid panel 9,156 8,553 $36K
72100 1,898 1,736 $36K
88305 Level IV - Surgical pathology, gross and microscopic examination 4,771 4,272 $36K
76642 349 330 $35K
64635 77 49 $35K
S0028 Injection, famotidine, 20 mg 741 511 $34K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 10,090 7,451 $33K
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 978 769 $33K
J7030 Infusion, normal saline solution , 1000 cc 1,399 1,073 $32K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,032 977 $32K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 17,293 14,567 $32K
99281 Emergency department visit for the evaluation and management, self-limited or minor 336 306 $32K
73130 1,724 1,493 $31K
73630 1,987 1,740 $29K
77063 Screening digital breast tomosynthesis, bilateral 993 953 $27K
72125 Computed tomography, cervical spine; without contrast material 1,531 1,361 $26K
96367 410 280 $26K
84439 5,359 4,764 $26K
82607 6,053 5,629 $25K
71045 Radiologic examination, chest; single view 8,163 6,967 $24K
87653 1,445 1,351 $24K
73030 1,243 1,071 $24K
73610 1,223 1,090 $24K
73562 1,582 1,353 $23K
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 2,869 2,369 $22K
84484 15,745 10,573 $22K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 3,947 3,778 $22K
86803 2,783 2,648 $21K
85027 8,421 7,236 $20K
87086 Culture, bacterial; quantitative colony count, urine 6,903 6,152 $19K
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) 865 783 $18K
93246 479 450 $18K
62321 29 28 $18K
76775 183 171 $17K
71271 157 155 $16K
84702 2,189 1,688 $16K
70486 202 192 $15K
87088 5,543 4,827 $15K
96375 Therapeutic injection; each additional sequential IV push 13,627 10,045 $15K
94729 461 421 $13K
82728 3,326 2,926 $13K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 5,721 2,593 $13K
87070 2,103 1,859 $13K
86850 3,180 2,750 $13K
90715 857 795 $12K
80329 1,599 777 $12K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 1,444 1,306 $12K
0001A 578 534 $12K
87077 5,321 4,786 $11K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 882 757 $11K
64494 57 53 $11K
82950 1,601 1,550 $11K
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 474 457 $10K
86140 3,562 3,123 $10K
83605 6,132 4,648 $10K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,857 1,742 $10K
82565 1,653 1,461 $10K
J7120 Ringers lactate infusion, up to 1000 cc 2,782 2,429 $10K
73110 508 448 $10K
76830 Ultrasound, transvaginal 137 127 $10K
96376 4,734 3,027 $10K
J2250 Injection, midazolam hydrochloride, per 1 mg 9,213 8,027 $9K
95806 13 12 $9K
86901 3,077 2,633 $9K
80143 1,572 1,333 $9K
97035 217 79 $8K
94726 325 293 $8K
85379 1,897 1,732 $8K
0002A 255 247 $8K
85610 6,501 4,930 $8K
81003 4,822 4,199 $7K
80055 999 948 $7K
87186 4,414 3,917 $7K
84112 331 277 $6K
59025 Fetal non-stress test 36 28 $6K
82140 2,710 2,186 $6K
83735 7,950 5,582 $6K
76770 52 50 $6K
83540 3,634 3,270 $5K
83550 1,928 1,771 $5K
73502 468 402 $5K
J1885 Injection, ketorolac tromethamine, per 15 mg 11,936 10,419 $5K
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 514 438 $5K
83970 340 312 $5K
93922 62 60 $5K
82746 1,637 1,506 $5K
82105 537 511 $5K
12001 25 25 $5K
J2405 Injection, ondansetron hydrochloride, per 1 mg 19,434 15,809 $4K
85652 3,798 3,287 $4K
80076 1,259 1,137 $4K
62323 18 15 $4K
S0020 Injection, bupivicaine hydrochloride, 30 ml 1,183 1,070 $4K
84481 564 521 $4K
82570 2,512 2,200 $4K
86592 1,180 1,126 $4K
83615 3,066 2,477 $4K
80320 1,210 1,041 $4K
70496 27 26 $4K
84550 2,036 1,720 $4K
87015 753 712 $4K
84156 1,342 1,082 $4K
83690 13,050 11,127 $4K
84145 355 313 $4K
84703 4,125 3,736 $4K
86900 3,190 2,639 $4K
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 14 14 $3K
87522 Neg quan hep c or qual rna 243 226 $3K
J3010 Injection, fentanyl citrate, 0.1 mg 9,799 8,443 $3K
94010 93 75 $3K
J2469 Injection, palonosetron hcl, 25 mcg 45 24 $3K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 184 142 $3K
87340 1,480 1,403 $3K
73080 100 90 $3K
70491 29 26 $3K
84403 262 253 $3K
87081 834 781 $3K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 26 26 $3K
95886 23 16 $3K
97166 55 49 $3K
Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml 29 26 $3K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 54 50 $2K
10060 12 12 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,081 931 $2K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 269 199 $2K
C1729 Catheter, drainage 375 334 $2K
85730 2,108 1,762 $2K
84100 2,859 2,126 $2K
J8540 Dexamethasone, oral, 0.25 mg 783 373 $2K
S0077 Injection, clindamycin phosphate, 300 mg 166 136 $2K
96523 29 26 $2K
S0164 Injection, pantoprazole sodium, 40 mg 29 27 $2K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 13,340 10,917 $2K
70498 40 39 $2K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 33 30 $2K
43450 29 28 $2K
74022 162 140 $2K
73590 236 203 $2K
84153 225 211 $2K
82043 1,515 1,405 $2K
80164 331 306 $2K
93880 13 12 $2K
93225 39 37 $2K
97014 102 26 $2K
88312 1,721 1,573 $1K
94375 37 36 $1K
82803 1,290 1,037 $1K
86141 723 622 $1K
94060 49 41 $1K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 15 15 $1K
99152 499 408 $1K
76000 152 140 $1K
87205 1,789 1,544 $1K
84466 974 820 $1K
29125 15 12 $1K
97163 61 43 $1K
80179 1,519 1,294 $1K
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care 69 25 $1K
J0780 Injection, prochlorperazine, up to 10 mg 1,364 1,169 $1K
82533 465 365 $1K
77002 13 13 $1K
82731 17 14 $1K
86762 672 644 $1K
64636 14 13 $1K
93242 25 25 $998.10
36591 160 84 $800.53
87807 584 562 $795.16
J1650 Injection, enoxaparin sodium, 10 mg 928 545 $752.20
73090 100 90 $724.18
86038 160 150 $716.03
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 14 12 $699.62
71101 66 62 $664.36
93226 39 37 $653.31
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 5,102 2,261 $604.14
80074 63 57 $598.29
94762 103 64 $585.87
G0379 Direct admission of patient for hospital observation care 16 14 $583.94
86704 175 165 $568.61
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 211 149 $557.27
84681 141 128 $521.31
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 1,952 1,583 $510.05
84146 53 51 $505.58
82272 70 65 $486.91
88300 691 651 $467.04
J2270 Injection, morphine sulfate, up to 10 mg 5,227 3,947 $435.51
Q0162 Ondansetron 1 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 1,509 1,117 $415.00
J2785 Injection, regadenoson, 0.1 mg 670 617 $406.72
J0696 Injection, ceftriaxone sodium, per 250 mg 4,886 3,747 $388.42
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 203 155 $384.40
82550 326 263 $371.35
J1200 Injection, diphenhydramine hcl, up to 50 mg 3,035 2,183 $306.73
72050 20 19 $291.44
86376 27 25 $285.38
88304 846 785 $282.06
99153 Mod sedat endo service >5yrs 978 871 $280.93
87147 307 274 $279.37
88307 15 14 $244.98
J1170 Injection, hydromorphone, up to 4 mg 4,230 2,895 $237.84
97167 14 13 $234.22
86706 73 70 $225.85
J2765 Injection, metoclopramide hcl, up to 10 mg 1,311 1,117 $216.40
94664 233 186 $209.56
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 919 841 $205.36
82977 77 74 $202.19
86800 24 24 $188.66
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 92 56 $187.93
J0690 Injection, cefazolin sodium, 500 mg 3,258 2,732 $186.41
85045 215 200 $173.78
82248 75 53 $156.24
83001 15 15 $152.54
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 659 526 $149.82
J2704 Injection, propofol, 10 mg 12,799 11,313 $141.62
J0330 Injection, succinylcholine chloride, up to 20 mg 1,921 1,706 $141.50
86308 13 13 $134.29
81050 56 53 $128.69
83993 12 12 $124.04
36600 35 25 $119.00
J0171 Injection, adrenalin, epinephrine, 0.1 mg 285 218 $118.38
87449 25 25 $110.82
86430 58 50 $101.80
88302 52 38 $99.36
87210 108 97 $84.97
J2795 Injection, ropivacaine hydrochloride, 1 mg 895 816 $80.75
83721 15 13 $77.97
85018 50 42 $68.68
86003 18 14 $66.67
J2060 Injection, lorazepam, 2 mg 992 747 $57.47
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 27 14 $56.29
72170 29 25 $56.28
80156 12 12 $55.12
82378 31 28 $54.93
J1644 Injection, heparin sodium, per 1000 units 1,261 640 $52.56
83002 13 13 $51.47
88342 195 172 $47.48
84402 12 12 $45.71
86708 18 18 $43.65
85007 98 82 $41.50
J2370 Injection, phenylephrine hcl, up to 1 ml 476 419 $41.15
J1815 Injection, insulin, per 5 units 287 127 $40.76
J1956 Injection, levofloxacin, 250 mg 534 437 $35.29
82150 29 24 $32.52
J2550 Injection, promethazine hcl, up to 50 mg 613 473 $31.82
86431 13 12 $31.72
J2919 Injection, methylprednisolone sodium succinate, 5 mg 262 219 $31.64
84460 15 12 $22.98
C9113 Injection, pantoprazole sodium, per vial 461 275 $21.84
84450 15 12 $17.88
J1171 Injection, hydromorphone, 0.1 mg 97 63 $12.50
J2360 Injection, orphenadrine citrate, up to 60 mg 502 466 $11.87
88341 15 12 $10.22
J3475 Injection, magnesium sulfate, per 500 mg 177 93 $10.06
82009 76 71 $9.94
J3480 Injection, potassium chloride, per 2 meq 114 68 $8.21
J1040 Injection, methylprednisolone acetate, 80 mg 112 94 $6.23
C1769 Guide wire 315 283 $5.38
94760 865 629 $4.79
J3370 Injection, vancomycin hcl, 500 mg 36 27 $3.29
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 16 15 $2.04
J2274 Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg 1,596 1,521 $1.52
J1940 Injection, furosemide, up to 20 mg 25 13 $0.91
94761 1,189 748 $0.43
J1030 Injection, methylprednisolone acetate, 40 mg 69 38 $0.17
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 950 864 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 1,017 921 $0.00
J8499 Prescription drug, oral, non chemotherapeutic, nos 23 17 $0.00
96417 19 12 $0.00
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 15 15 $0.00
J1953 Injection, levetiracetam, 10 mg 16 12 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 14 12 $0.00
A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml 38 24 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 12 12 $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 27 14 $0.00
A9270 Non-covered item or service 782 616 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 160 142 $0.00
J2471 Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg 18 12 $0.00
J0173 Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg 71 53 $0.00
J1630 Injection, haloperidol, up to 5 mg 19 12 $0.00
96368 42 38 $0.00
V2632 Posterior chamber intraocular lens 108 82 $0.00
J1010 Injection, methylprednisolone acetate, 1 mg 49 46 $0.00
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 13 13 $0.00
Q9963 High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml 26 25 $0.00
84132 15 12 $0.00
74019 12 12 $0.00
J0360 Injection, hydralazine hcl, up to 20 mg 22 12 $0.00