Medicaid Provider Spending

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

LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC

NPI: 1134220031 · SAINT JOSEPH, MI 49085 · General Acute Care Hospital · NPI assigned 09/26/2006

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

Authorized official COX, MATTHEW controls 20+ related entities in our dataset. Read more

$78.22M
Total Medicaid Paid
2,391,298
Total Claims
2,000,315
Beneficiaries
576
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialCOX, MATTHEW (CFO)
NPI Enumeration Date09/26/2006

Related Entities

Other providers sharing the same authorized official: COX, MATTHEW

ProviderCityStateTotal Paid
SPECTRUM HEALTH HOSPITALS GRAND RAPIDS MI $243.22M
OAKWOOD HEALTHCARE, INC. DEARBORN MI $165.61M
WILLIAM BEAUMONT HOSPITAL ROYAL OAK MI $162.64M
WILLIAM BEAUMONT HOSPITAL TROY MI $84.88M
BOTSFORD GENERAL HOSPITAL FARMINGTON HILLS MI $72.21M
WILLIAM BEAUMONT HOSPITAL GROSSE POINTE MI $61.49M
OAKWOOD HEALTHCARE, INC. WAYNE MI $55.44M
OAKWOOD HEALTHCARE, INC. TAYLOR MI $50.28M
OAKWOOD HEALTHCARE, INC. TRENTON MI $23.26M
SPECTRUM HEALTH UNITED GREENVILLE MI $20.99M
MECOSTA COUNTY MEDICAL CENTER BIG RAPIDS MI $19.50M
PENNOCK HOSPITAL HASTINGS MI $15.24M
REED CITY HOSPITAL CORPORATION REED CITY MI $15.02M
ZEELAND COMMUNITY HOSPITAL ZEELAND MI $10.12M
LAKELAND COMMUNITY HOSPITAL WATERVLIET WATERVLIET MI $9.85M
LAKELAND COMMUNITY HOSPITAL WATERVLIET NILES MI $9.05M
VISITING NURSE SERVICES OF WESTERN MICHIGAN GRAND RAPIDS MI $4.54M
LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC BENTON HARBOR MI $3.33M
BANNER MESA SURGERY CENTER LLC MESA AZ $2.80M
LAKELAND COMMUNITY HOSPITAL WATERVLIET WATERVLIET MI $2.55M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 316,020 $9.24M
2019 302,884 $9.26M
2020 298,027 $9.20M
2021 382,972 $12.61M
2022 369,818 $12.57M
2023 401,568 $14.00M
2024 320,009 $11.34M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99284 Emergency department visit for the evaluation and management, high severity 53,510 47,387 $10.52M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 31,763 28,528 $9.96M
99283 Emergency department visit for the evaluation and management, moderate severity 75,907 70,591 $9.42M
G0378 Hospital observation service, per hour 21,497 13,480 $7.24M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 38,365 32,200 $3.64M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 79,159 25,121 $1.83M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 26,135 20,778 $1.59M
74177 Computed tomography, abdomen and pelvis; with contrast material 10,079 9,799 $1.45M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 15,197 11,115 $1.35M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 11,366 8,150 $1.18M
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 6,845 4,449 $1.14M
96375 Therapeutic injection; each additional sequential IV push 33,022 25,368 $941K
99282 Emergency department visit for the evaluation and management, low to moderate severity 13,113 12,822 $931K
96361 Intravenous infusion, hydration; each additional hour 27,092 22,108 $898K
45380 Colonoscopy, flexible; with biopsy, single or multiple 1,755 1,736 $890K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 3,377 2,271 $841K
42820 Tonsillectomy and adenoidectomy; younger than age 12 276 275 $775K
71046 Radiologic examination, chest; 2 views 19,823 18,806 $761K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 31,002 13,250 $677K
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 12,560 12,120 $651K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 8,443 8,276 $605K
95810 Polysomnography; sleep staging with 4 or more additional parameters 1,180 1,173 $602K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,747 1,737 $573K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 5,823 5,407 $566K
70450 Computed tomography, head or brain; without contrast material 6,811 6,512 $547K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 8,290 8,064 $523K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 11,796 4,045 $484K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 29,736 11,855 $439K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 2,105 2,089 $407K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 861 842 $394K
97530 Therapeutic activities, direct patient contact, each 15 minutes 16,245 7,612 $387K
77067 Screening mammography, bilateral, including computer-aided detection 7,809 7,801 $381K
71045 Radiologic examination, chest; single view 9,497 8,957 $329K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 5,449 5,414 $325K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 943 844 $319K
71260 Computed tomography, thorax, diagnostic; with contrast material 2,368 2,349 $318K
93975 2,481 2,415 $301K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 20,208 19,801 $296K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 20,189 19,787 $293K
15275 312 141 $289K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 5,660 5,389 $283K
76830 Ultrasound, transvaginal 4,822 4,730 $280K
99281 Emergency department visit for the evaluation and management, self-limited or minor 7,126 6,921 $280K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,476 1,000 $275K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 567 561 $271K
97162 5,573 5,509 $265K
76705 Ultrasound, abdominal, real time with image documentation; limited 4,698 4,587 $265K
80061 Lipid panel 23,781 23,591 $262K
97161 5,431 5,341 $257K
76801 4,407 4,109 $257K
80053 Comprehensive metabolic panel 114,637 96,986 $234K
74176 Computed tomography, abdomen and pelvis; without contrast material 2,127 2,097 $230K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 4,498 4,415 $229K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 4,529 4,454 $228K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5,193 5,058 $216K
76700 Ultrasound, abdominal, real time with image documentation; complete 3,425 3,383 $210K
71275 Computed tomographic angiography, chest, with contrast material 2,500 2,444 $206K
86900 7,197 6,893 $204K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 1,672 1,626 $202K
84443 Thyroid stimulating hormone (TSH) 29,134 28,651 $199K
36415 Collection of venous blood by venipuncture 163,904 130,506 $178K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 2,171 2,158 $169K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 3,734 2,591 $167K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,636 1,632 $166K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 112,611 93,298 $163K
93458 272 189 $150K
76770 2,611 2,543 $148K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 9,872 9,779 $138K
96367 4,198 2,918 $137K
94060 1,389 910 $132K
97597 1,378 914 $128K
93971 2,287 2,232 $128K
96415 2,610 2,021 $127K
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 8,103 7,870 $126K
47562 55 55 $123K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,455 1,439 $118K
87507 697 685 $112K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 15,926 12,936 $110K
76819 Fetal biophysical profile; without non-stress testing 1,776 1,003 $108K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 33,957 28,696 $107K
10060 1,139 1,103 $104K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 23,273 22,291 $95K
72141 625 621 $89K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 36,061 31,143 $88K
S4005 Interim labor facility global (labor occurring but not resulting in delivery) 775 666 $85K
92523 1,086 1,076 $85K
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 8,609 7,140 $84K
97165 1,818 1,803 $83K
92526 1,810 804 $82K
J2785 Injection, regadenoson, 0.1 mg 1,296 1,292 $81K
99244 Office or other outpatient consultation, moderate to high complexity 892 877 $81K
72110 2,549 2,537 $81K
76642 2,051 2,034 $80K
99232 Subsequent hospital care, per day, moderate complexity 2,444 938 $77K
83036 Hemoglobin; glycosylated (A1C) 19,358 19,147 $77K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 4,449 3,188 $75K
88142 6,543 6,525 $75K
78815 Positron emission tomography (PET) for limited area imaging 96 93 $73K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,247 1,246 $72K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 3,286 3,186 $72K
59025 Fetal non-stress test 743 509 $70K
J9271 Injection, pembrolizumab, 1 mg 15 12 $69K
76536 1,366 1,360 $68K
70551 Magnetic resonance imaging, brain; without contrast material 862 851 $68K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 3,224 3,218 $63K
71271 1,206 1,204 $63K
71250 1,008 1,005 $62K
99215 Prolong outpt/office vis 635 618 $59K
70491 528 518 $58K
86850 8,450 8,208 $57K
73562 1,922 1,917 $57K
88305 Level IV - Surgical pathology, gross and microscopic examination 8,628 8,192 $55K
96417 1,330 925 $54K
73030 4,054 3,982 $53K
73221 424 414 $51K
86480 1,617 1,607 $50K
97166 1,454 1,419 $49K
85027 21,663 20,370 $49K
97535 Self-care/home management training, each 15 minutes 3,016 1,910 $48K
70496 1,152 1,126 $46K
77063 Screening digital breast tomosynthesis, bilateral 3,585 3,585 $46K
87088 25,386 23,585 $45K
86780 6,069 6,037 $45K
83970 2,337 2,297 $44K
73630 4,605 4,520 $42K
95811 81 80 $41K
72100 1,723 1,712 $41K
77066 Tomosynthesis, mammo 697 694 $41K
82728 7,070 6,886 $37K
96523 1,588 1,246 $37K
82607 6,240 6,149 $37K
73130 4,192 4,068 $36K
J2469 Injection, palonosetron hcl, 25 mcg 2,947 1,793 $36K
97116 3,087 1,740 $36K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 3,207 3,014 $36K
87086 Culture, bacterial; quantitative colony count, urine 19,745 18,712 $34K
93017 1,462 1,453 $34K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,421 3,333 $32K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 4,908 4,881 $32K
80048 Basic metabolic panel (calcium, ionized) 14,673 12,140 $31K
73110 2,835 2,676 $31K
93308 532 421 $31K
Q5111 Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg 16 12 $30K
84439 7,472 7,374 $30K
99222 Initial hospital care, per day, moderate complexity 525 501 $30K
73502 2,137 2,115 $30K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 1,450 1,442 $29K
74018 1,835 1,738 $29K
73610 3,981 3,832 $28K
70486 766 754 $27K
36430 178 138 $26K
73564 3,804 3,744 $25K
80074 1,360 1,353 $25K
87536 536 533 $25K
72040 1,312 1,276 $25K
77065 Tomosynthesis, mammo 723 671 $25K
93000 2,839 2,803 $24K
87340 6,601 6,563 $24K
87077 8,936 8,489 $23K
93970 217 217 $23K
97163 419 419 $22K
99205 Prolong outpt/office vis 211 210 $22K
86803 4,270 4,257 $22K
99254 261 249 $22K
83550 6,928 6,756 $22K
93798 335 48 $22K
29580 240 127 $22K
82947 1,588 1,084 $21K
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk 52 52 $21K
P9016 Red blood cells, leukocytes reduced, each unit 260 204 $21K
87186 8,766 8,394 $20K
72156 127 127 $20K
87905 10,070 9,820 $19K
84153 2,190 2,169 $19K
87808 9,453 9,225 $19K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 62 62 $19K
93015 725 724 $19K
85610 15,844 12,080 $19K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 673 673 $19K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 378 374 $18K
82043 5,865 5,830 $18K
84702 14,867 12,999 $17K
83540 7,093 6,915 $17K
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 678 677 $17K
72125 Computed tomography, cervical spine; without contrast material 1,813 1,756 $16K
72050 386 386 $16K
77336 223 102 $15K
99243 237 237 $15K
99223 Prolong inpt eval add15 m 161 149 $15K
86140 8,114 7,272 $15K
84403 1,085 1,070 $14K
82746 2,304 2,279 $14K
99233 Prolong inpt eval add15 m 218 118 $13K
93016 1,078 1,077 $13K
J7050 Infusion, normal saline solution, 250 cc 35,473 21,127 $13K
73140 1,909 1,861 $13K
72072 534 532 $13K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 5,398 5,338 $13K
G0297 Low dose ct scan (ldct) for lung cancer screening 361 361 $13K
93018 1,533 1,528 $13K
83880 3,363 3,115 $12K
86360 474 470 $12K
76870 784 769 $12K
80076 2,912 2,732 $12K
72158 125 125 $12K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 2,057 1,845 $11K
93880 110 110 $11K
86762 2,979 2,965 $11K
83735 21,889 18,869 $11K
81001 50,589 46,476 $11K
74183 66 65 $11K
88307 594 581 $11K
73080 1,522 1,475 $11K
J0561 Injection, penicillin g benzathine, 100,000 units 100 100 $11K
97035 1,790 718 $11K
86038 2,065 2,040 $11K
G0475 Hiv antigen/antibody, combination assay, screening 816 813 $10K
86300 1,576 1,471 $10K
82784 1,696 1,547 $10K
0012A 332 332 $10K
87390 1,006 1,002 $10K
86359 474 470 $10K
87081 3,184 3,157 $10K
84207 714 710 $10K
86003 245 242 $10K
84481 1,025 1,019 $8K
80306 2,729 2,566 $8K
99238 Hospital discharge day management, 30 minutes or less 299 294 $8K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 1,304 1,285 $8K
81511 538 537 $8K
82950 3,007 2,993 $8K
85652 7,637 7,003 $8K
29515 99 99 $8K
83001 818 816 $8K
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 30 30 $7K
85576 471 468 $7K
88304 2,037 1,992 $7K
95806 88 88 $7K
83921 690 686 $7K
93296 529 520 $7K
86702 1,006 1,002 $7K
84146 729 718 $7K
99231 Subsequent hospital care, per day, straightforward or low complexity 672 231 $7K
M0245 Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring 25 25 $7K
97012 1,052 405 $7K
88342 437 425 $7K
84425 650 646 $7K
99152 2,270 1,840 $7K
0011A 340 340 $7K
G0103 Prostate cancer screening; prostate specific antigen test (psa) 618 618 $6K
77080 103 103 $6K
87070 2,723 2,602 $6K
80050 General health panel 226 226 $6K
82570 3,386 3,103 $6K
93925 66 66 $6K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 8,124 6,750 $6K
73590 999 963 $6K
86376 981 969 $6K
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 495 495 $5K
93922 172 172 $5K
43235 13 13 $5K
99239 Hospital discharge day management, more than 30 minutes 89 88 $5K
83655 814 805 $5K
90675 35 13 $5K
96411 140 88 $5K
70498 1,147 1,121 $5K
74240 53 53 $5K
83516 584 573 $5K
86701 1,040 1,036 $5K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 1,158 1,151 $5K
80069 1,125 1,038 $4K
93295 208 202 $4K
87102 1,025 1,002 $4K
97802 291 291 $4K
94726 1,130 711 $4K
85730 7,346 6,872 $4K
87653 269 268 $4K
73700 68 66 $4K
80164 955 889 $4K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 341 341 $4K
86706 916 910 $4K
97014 484 222 $4K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 14 14 $4K
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 196 196 $4K
93298 172 163 $4K
0031A 101 100 $4K
96416 19 12 $4K
73090 826 795 $4K
93793 1,622 971 $4K
83690 25,249 22,658 $3K
M0247 Intravenous infusion, sotrovimab, includes infusion and post administration monitoring 14 14 $3K
72146 25 24 $3K
84156 2,803 2,504 $3K
A9577 Injection, gadobenate dimeglumine (multihance), per ml 1,680 1,649 $3K
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 183 172 $3K
86431 1,384 1,377 $3K
82378 834 617 $3K
86235 157 152 $3K
83002 309 309 $3K
82550 2,216 1,919 $3K
84550 1,862 1,724 $3K
94729 1,228 776 $3K
97763 70 51 $3K
84402 214 213 $3K
93248 164 163 $2K
86161 228 217 $2K
29581 29 12 $2K
0001A 72 72 $2K
97760 89 88 $2K
87206 1,755 1,704 $2K
83615 2,279 1,887 $2K
73560 103 101 $2K
82670 148 146 $2K
86364 327 324 $2K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 116 116 $2K
84100 1,424 1,146 $2K
95819 30 30 $2K
82247 778 501 $2K
71101 335 334 $2K
84630 311 310 $2K
99406 230 213 $2K
87522 Neg quan hep c or qual rna 93 91 $2K
82533 233 220 $2K
M0239 Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring 12 12 $2K
93246 162 159 $2K
82525 282 280 $2K
80329 45 43 $2K
82951 218 215 $2K
72157 24 24 $1K
99255 14 13 $1K
85055 146 91 $1K
93351 12 12 $1K
74022 239 234 $1K
0002A 36 36 $1K
86225 218 216 $1K
97803 135 131 $1K
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r 16 12 $1K
81025 21,895 20,828 $1K
86200 294 286 $1K
86618 188 185 $1K
84484 18,875 14,103 $1K
85379 4,514 4,398 $923.60
87631 414 405 $918.26
87338 116 115 $914.43
00811 14 14 $900.42
85045 1,325 893 $897.23
99442 58 58 $892.99
72082 13 13 $845.65
86665 51 50 $841.01
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 49 43 $811.80
87563 45 45 $805.98
93325 459 382 $796.17
87040 5,506 4,147 $794.88
73660 90 89 $791.01
82024 43 42 $739.27
80177 671 573 $736.73
0064A 20 19 $721.04
86769 31 31 $705.84
86160 64 59 $679.32
82785 92 92 $663.39
86147 29 27 $638.38
87529 40 36 $628.74
93272 43 43 $602.84
90686 68 67 $585.62
99221 13 13 $576.40
84145 1,772 1,610 $560.37
76000 192 183 $552.94
84446 72 72 $548.56
86308 499 489 $533.77
72170 25 25 $519.77
0004A 14 14 $506.07
12001 1,671 1,662 $505.97
92610 13 13 $500.47
94618 49 27 $479.28
84590 75 75 $462.86
84681 42 41 $459.06
76376 220 182 $438.32
82330 376 342 $437.04
82977 122 109 $435.58
86592 169 169 $384.53
84165 88 83 $380.56
93227 25 25 $372.09
94762 67 44 $354.49
82274 43 41 $350.24
85014 1,308 1,150 $348.77
85018 1,099 920 $347.01
73060 79 78 $340.05
82248 144 109 $335.50
82627 31 31 $331.44
73521 12 12 $330.68
84112 120 103 $322.02
83605 7,171 5,991 $314.71
12011 609 605 $305.04
73070 15 14 $285.89
P9603 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled 1,075 965 $285.59
0240U 298 287 $285.26
86704 56 56 $276.46
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 467 459 $275.11
99443 12 12 $270.96
94010 38 24 $255.43
86800 37 37 $245.90
87210 813 804 $242.83
96401 24 14 $242.32
83993 24 24 $231.43
87205 222 207 $226.98
G0008 Administration of influenza virus vaccine 68 67 $214.22
76937 669 622 $211.76
82952 106 104 $208.51
93321 64 55 $208.42
86708 27 26 $188.62
93242 14 14 $180.45
93244 13 13 $179.36
86255 25 25 $169.20
93356 40 26 $166.71
82565 105 95 $157.76
82010 2,064 1,826 $155.09
87641 43 43 $138.96
80197 19 12 $136.68
99441 17 16 $134.64
82553 28 28 $121.52
86304 14 13 $117.72
86696 13 13 $108.00
82731 13 13 $106.40
83520 57 56 $103.95
85007 200 173 $99.84
84132 369 337 $99.12
73552 47 45 $96.47
82140 33 26 $95.60
86664 14 14 $94.71
90715 2,887 2,880 $91.86
85046 60 43 $84.79
J1885 Injection, ketorolac tromethamine, per 15 mg 36,327 32,054 $78.88
86735 12 12 $73.80
82105 12 12 $73.36
86765 12 12 $72.81
96376 12,367 7,325 $68.23
86695 13 13 $66.24
J2405 Injection, ondansetron hydrochloride, per 1 mg 32,218 25,399 $52.02
J3010 Injection, fentanyl citrate, 0.1 mg 8,349 7,236 $50.20
82150 14 14 $48.84
82803 732 661 $39.76
81003 593 424 $39.36
94664 1,811 1,392 $36.75
85660 12 12 $34.10
29125 853 838 $33.39
80178 14 13 $29.52
J2250 Injection, midazolam hydrochloride, per 1 mg 13,136 11,857 $27.71
86901 6,543 6,280 $20.50
J7030 Infusion, normal saline solution , 1000 cc 9,848 8,337 $18.46
J0696 Injection, ceftriaxone sodium, per 250 mg 8,349 7,126 $18.13
84480 24 23 $17.82
J0330 Injection, succinylcholine chloride, up to 20 mg 2,863 2,803 $14.68
86787 15 15 $14.10
J2360 Injection, orphenadrine citrate, up to 60 mg 4,021 3,860 $12.24
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 11,866 11,180 $11.94
J1644 Injection, heparin sodium, per 1000 units 6,270 2,948 $11.92
84295 155 145 $11.26
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 4,596 4,170 $11.16
J1100 Injection, dexamethasone sodium phosphate, 1 mg 19,525 17,446 $10.89
J0131 Injection, acetaminophen, not otherwise specified,10 mg 8,547 7,923 $10.67
87075 15 15 $10.18
82077 579 515 $9.45
A9270 Non-covered item or service 4,650 2,350 $7.70
J0171 Injection, adrenalin, epinephrine, 0.1 mg 322 312 $7.40
J1200 Injection, diphenhydramine hcl, up to 50 mg 9,706 6,315 $5.05
J8597 Antiemetic drug, oral, not otherwise specified 7,371 6,852 $3.90
91303 65 64 $1.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 3,046 2,520 $0.62
J0780 Injection, prochlorperazine, up to 10 mg 4,070 3,691 $0.26
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 20 13 $0.24
J2060 Injection, lorazepam, 2 mg 4,857 3,658 $0.20
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 3,084 2,867 $0.06
Q0163 Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen 2,528 2,354 $0.01
J2370 Injection, phenylephrine hcl, up to 1 ml 1,176 1,115 $0.00
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 1,234 946 $0.00
J3490 Unclassified drugs 3,140 2,449 $0.00
J1940 Injection, furosemide, up to 20 mg 1,191 771 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 2,287 1,335 $0.00
J1790 Injection, droperidol, up to 5 mg 1,505 1,262 $0.00
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 86 83 $0.00
J1170 Injection, hydromorphone, up to 4 mg 2,450 1,618 $0.00
J1815 Injection, insulin, per 5 units 2,628 1,390 $0.00
C1769 Guide wire 1,355 1,264 $0.00
J8540 Dexamethasone, oral, 0.25 mg 1,442 1,402 $0.00
J3480 Injection, potassium chloride, per 2 meq 904 629 $0.00
J1630 Injection, haloperidol, up to 5 mg 930 711 $0.00
J2765 Injection, metoclopramide hcl, up to 10 mg 4,550 4,162 $0.00
12002 640 637 $0.00
J7999 Compounded drug, not otherwise classified 840 830 $0.00
J0690 Injection, cefazolin sodium, 500 mg 3,206 2,757 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 160 105 $0.00
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 611 242 $0.00
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 302 258 $0.00
99153 Mod sedat endo service >5yrs 1,677 1,647 $0.00
76377 362 361 $0.00
J2175 Injection, meperidine hydrochloride, per 100 mg 201 183 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 888 772 $0.00
J2704 Injection, propofol, 10 mg 4,808 4,652 $0.00
C1889 Implantable/insertable device, not otherwise classified 280 269 $0.00
J3411 Injection, thiamine hcl, 100 mg 1,057 733 $0.00
80051 29 26 $0.00
95886 12 12 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 205 197 $0.00
J0360 Injection, hydralazine hcl, up to 20 mg 13 12 $0.00
74420 29 24 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 416 392 $0.00
99024 144 95 $0.00
88300 162 151 $0.00
36416 269 225 $0.00
A9573 Injection, gadopiclenol, 1 ml 383 372 $0.00
J7060 5% dextrose/water (500 ml = 1 unit) 210 112 $0.00
91301 684 616 $0.00
A9585 Injection, gadobutrol, 0.1 ml 78 78 $0.00
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 13 12 $0.00
96368 90 68 $0.00
88341 13 13 $0.00
97010 360 179 $0.00
J7042 5% dextrose/normal saline (500 ml = 1 unit) 33 28 $0.00
29130 65 65 $0.00
J3360 Injection, diazepam, up to 5 mg 43 39 $0.00
C2617 Stent, non-coronary, temporary, without delivery system 17 14 $0.00
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg 82 67 $0.00
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals 13 12 $0.00
J0500 Injection, dicyclomine hcl, up to 20 mg 39 37 $0.00
C1726 Catheter, balloon dilatation, non-vascular 12 12 $0.00
80320 59 56 $0.00
91306 19 19 $0.00
C1781 Mesh (implantable) 15 12 $0.00
Q4196 Puraply am, per square centimeter (add-on, list separately in addition to primary procedure) 137 63 $0.00
J7644 Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram 16 14 $0.00
J9045 Injection, carboplatin, 50 mg 17 14 $0.00
30140 15 15 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 11,168 9,969 $0.00
J1650 Injection, enoxaparin sodium, 10 mg 2,068 1,083 $0.00
J3370 Injection, vancomycin hcl, 500 mg 991 546 $0.00
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) 1,985 1,959 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 3,147 2,636 $0.00
C9113 Injection, pantoprazole sodium, per vial 2,041 1,370 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 1,588 1,260 $0.00
J2550 Injection, promethazine hcl, up to 50 mg 4,817 2,643 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 785 698 $0.00
91300 189 148 $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 213 199 $0.00
J1756 Injection, iron sucrose, 1 mg 1,143 596 $0.00
76942 107 106 $0.00
J1953 Injection, levetiracetam, 10 mg 147 115 $0.00
C1758 Catheter, ureteral 90 78 $0.00
P9604 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge 84 37 $0.00
J7510 Prednisolone oral, per 5 mg 122 106 $0.00
J2270 Injection, morphine sulfate, up to 10 mg 1,696 1,377 $0.00
J2800 Injection, methocarbamol, up to 10 ml 87 84 $0.00
J9190 Injection, fluorouracil, 500 mg 151 49 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 319 314 $0.00
86922 43 38 $0.00
0722T 12 12 $0.00
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 52 36 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 195 162 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 253 247 $0.00
Q9957 Injection, perflutren lipid microspheres, per ml 53 53 $0.00
C1887 Catheter, guiding (may include infusion/perfusion capability) 62 61 $0.00
1124F 256 230 $0.00
80143 351 334 $0.00
89051 18 12 $0.00
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 56 54 $0.00
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 81 81 $0.00
J2916 Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg 51 28 $0.00
0097U 26 25 $0.00
Q0245 Injection, bamlanivimab and etesevimab, 2100 mg 17 17 $0.00
80179 347 333 $0.00
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 14 12 $0.00
J3105 Injection, terbutaline sulfate, up to 1 mg 17 12 $0.00
J0640 Injection, leucovorin calcium, per 50 mg 65 25 $0.00
0202U Oncology (prostate), multianalyte, gene expression profiling 13 13 $0.00
J1171 Injection, hydromorphone, 0.1 mg 315 142 $0.00
Q0243 Injection, casirivimab and imdevimab, 2400 mg 27 24 $0.00
J7070 Infusion, d5w, 1000 cc 63 27 $0.00