Medicaid Provider Spending

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

ARKANSAS CHILDRENS HOSPITAL

NPI: 1194776757 · LITTLE ROCK, AR 72202 · Critical Access Hospital Clinic/Center · NPI assigned 05/16/2006

$154.95M
Total Medicaid Paid
3,793,084
Total Claims
3,062,645
Beneficiaries
630
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialPHILLIPS, SHERYL (AR CONTROL MANAGER)
NPI Enumeration Date05/16/2006

Related Entities

Other providers sharing the same authorized official: PHILLIPS, SHERYL

ProviderCityStateTotal Paid
ARKANSAS CHILDRENS NORTHWEST, INC. SPRINGDALE AR $48.08M
ANGEL ONE ARKANSAS CHILDREN'S HOSPITAL LITTLE ROCK AR $20.06M
ARKANSAS CHILDRENS HOSPITAL LITTLE ROCK AR $6.93M
ARKANSAS CHILDREN'S HOSPITAL LITTLE ROCK AR $810K
ARKANSAS CHILDREN'S HOSPITAL LITTLE ROCK AR $65K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 578,745 $12.35M
2019 559,958 $20.59M
2020 484,589 $20.22M
2021 530,309 $25.88M
2022 527,215 $26.59M
2023 578,003 $26.48M
2024 534,265 $22.83M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 932,656 730,225 $13.19M
J0585 Injection, onabotulinumtoxina, 1 unit 4,095 3,359 $10.68M
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 28,879 25,104 $7.41M
J1745 Injection, infliximab, excludes biosimilar, 10 mg 2,531 1,900 $5.67M
70551 Magnetic resonance imaging, brain; without contrast material 12,152 10,304 $5.47M
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 68,435 57,679 $4.74M
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 29,483 25,878 $4.36M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 11,824 10,517 $3.58M
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 18,896 16,075 $2.85M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 6,543 5,681 $2.72M
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 4,214 3,421 $2.60M
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 29,072 25,227 $2.33M
70450 Computed tomography, head or brain; without contrast material 11,407 9,629 $2.25M
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 32,757 29,204 $1.90M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 19,540 10,761 $1.70M
42820 Tonsillectomy and adenoidectomy; younger than age 12 4,295 4,012 $1.66M
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 29,619 26,058 $1.57M
95716 2,006 1,458 $1.51M
80053 Comprehensive metabolic panel 75,220 57,652 $1.45M
72141 3,000 2,550 $1.42M
88305 Level IV - Surgical pathology, gross and microscopic examination 10,403 9,079 $1.42M
85025 Blood count; complete (CBC), automated, and automated differential WBC count 114,125 88,340 $1.42M
72148 Magnetic resonance imaging, lumbar spine; without contrast material 2,770 2,354 $1.36M
87581 28,329 24,726 $1.34M
87486 28,335 24,727 $1.34M
72146 2,399 2,039 $1.25M
70543 1,233 987 $1.23M
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 17,791 14,924 $1.23M
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 17,759 14,891 $1.22M
95782 2,145 1,929 $1.21M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 19,130 7,348 $1.20M
95810 Polysomnography; sleep staging with 4 or more additional parameters 4,845 4,365 $1.13M
71046 Radiologic examination, chest; 2 views 42,262 36,016 $1.04M
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 14,745 12,885 $1.02M
93320 19,042 16,115 $966K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 3,682 3,533 $960K
36512 2,693 1,957 $953K
90686 58,533 49,260 $908K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 40,341 34,464 $857K
84443 Thyroid stimulating hormone (TSH) 28,278 25,270 $857K
74177 Computed tomography, abdomen and pelvis; with contrast material 3,223 2,673 $855K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 6,119 5,185 $852K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 1,955 1,681 $830K
77080 2,833 2,566 $786K
86003 8,540 7,523 $781K
80050 General health panel 9,799 8,841 $761K
94010 25,502 23,211 $753K
41899 Unlisted procedure, dentoalveolar structures 1,124 636 $726K
76770 13,819 12,364 $708K
83036 Hemoglobin; glycosylated (A1C) 33,301 29,508 $663K
42830 1,930 1,866 $657K
80061 Lipid panel 23,894 21,439 $642K
J0475 Injection, baclofen, 10 mg 191 164 $622K
72082 9,441 8,443 $621K
82728 23,772 20,248 $601K
95819 7,482 6,813 $600K
51798 2,293 2,023 $595K
54161 2,285 2,146 $583K
86901 13,666 8,125 $578K
84439 31,405 28,208 $573K
71260 Computed tomography, thorax, diagnostic; with contrast material 2,004 1,630 $507K
80048 Basic metabolic panel (calcium, ionized) 30,681 24,445 $504K
70486 1,794 1,584 $415K
92611 9,454 8,600 $404K
87086 Culture, bacterial; quantitative colony count, urine 28,686 24,990 $396K
81025 32,008 26,531 $390K
93325 22,001 18,661 $389K
90670 33,614 31,553 $377K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 512 309 $376K
84145 12,718 10,577 $376K
J1569 Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg 470 183 $369K
74022 9,554 8,362 $365K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 19,943 14,792 $364K
87631 2,430 2,298 $351K
95700 2,083 1,749 $350K
80069 17,237 12,365 $350K
83970 5,061 4,337 $336K
72125 Computed tomography, cervical spine; without contrast material 1,081 935 $330K
74018 11,379 10,178 $327K
85027 34,623 27,282 $321K
86140 37,583 31,028 $320K
90647 27,491 25,706 $314K
93975 2,488 2,114 $309K
97163 1,233 1,149 $309K
93226 3,651 3,151 $308K
90651 19,639 17,121 $306K
74019 9,609 8,153 $301K
72170 9,429 8,276 $297K
82803 7,840 5,891 $293K
81229 736 572 $292K
73630 8,128 5,987 $286K
83516 10,072 9,024 $281K
0071A 2,531 2,313 $275K
44970 661 546 $271K
90723 25,419 24,107 $271K
87077 15,456 13,113 $270K
36430 1,524 829 $268K
74230 9,992 9,072 $268K
87497 4,587 2,999 $267K
82784 19,716 16,472 $262K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 2,528 2,280 $260K
88185 2,405 2,054 $255K
76705 Ultrasound, abdominal, real time with image documentation; limited 10,661 9,018 $255K
83880 4,961 3,759 $246K
90633 22,803 20,924 $244K
77073 5,756 4,100 $243K
92523 6,459 5,372 $241K
87040 15,431 12,547 $241K
49452 265 213 $239K
82248 31,602 22,812 $239K
0072A 2,108 1,933 $238K
81003 60,977 49,175 $237K
83735 21,106 13,952 $236K
92587 4,776 4,396 $234K
97162 1,447 1,284 $230K
J1561 Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg 307 215 $221K
67311 472 447 $220K
86780 7,758 6,804 $219K
70480 928 831 $218K
90681 19,712 18,650 $218K
31526 645 590 $216K
73130 5,830 4,520 $215K
97530 Therapeutic activities, direct patient contact, each 15 minutes 3,797 1,357 $215K
82948 25,834 20,184 $215K
84703 14,631 11,409 $214K
0001A 3,079 2,803 $214K
81001 39,315 33,005 $209K
70491 883 725 $205K
83020 8,801 6,836 $204K
87070 14,955 11,952 $202K
73564 4,600 3,821 $201K
29405 606 543 $199K
90619 4,208 3,731 $198K
73590 7,106 5,357 $194K
J2405 Injection, ondansetron hydrochloride, per 1 mg 12,199 5,524 $194K
82977 15,941 12,787 $192K
76700 Ultrasound, abdominal, real time with image documentation; complete 2,897 2,531 $190K
92567 12,464 11,127 $177K
J1050 Injection, medroxyprogesterone acetate, 1 mg 7,538 6,592 $175K
93225 3,938 3,382 $174K
80197 8,664 4,953 $173K
73610 7,657 6,180 $172K
88342 2,947 2,489 $172K
95951 1,356 837 $168K
76376 6,277 5,497 $167K
82330 5,160 3,179 $165K
90715 10,559 9,441 $162K
73090 8,035 5,626 $161K
76536 2,597 2,294 $158K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 11,433 10,159 $156K
70250 5,446 4,354 $155K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 3,011 2,567 $154K
84305 3,742 3,467 $153K
90734 10,633 9,374 $151K
J9370 Vincristine sulfate, 1 mg 4,080 2,154 $150K
72081 4,451 3,923 $149K
77072 4,319 4,033 $147K
72197 146 126 $147K
73110 5,001 3,926 $144K
85046 16,313 12,319 $137K
76820 2,497 2,254 $137K
83550 8,640 7,196 $136K
0002A 1,547 1,491 $135K
86160 3,632 2,993 $134K
73560 4,339 3,182 $133K
76821 2,486 2,247 $132K
88184 2,748 2,331 $132K
97161 1,260 1,057 $131K
84100 16,142 10,795 $130K
83615 14,405 11,509 $129K
76885 2,541 2,297 $129K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 7,079 2,671 $128K
84146 2,654 2,378 $127K
76825 3,334 2,080 $125K
83690 10,563 8,647 $124K
51600 842 488 $123K
90700 11,146 10,261 $122K
86376 3,967 3,633 $120K
76827 3,411 2,084 $118K
82785 5,220 4,567 $117K
87186 9,712 8,381 $117K
90716 10,894 9,982 $117K
83540 9,201 7,959 $116K
94060 2,703 2,406 $115K
86922 780 444 $115K
90707 10,607 9,763 $114K
84460 12,168 10,253 $113K
90697 8,002 7,529 $113K
J3262 Injection, tocilizumab, 1 mg 56 37 $113K
93978 1,107 1,000 $112K
86703 7,519 6,147 $111K
86800 3,384 3,102 $111K
85652 22,481 18,912 $110K
93786 1,988 1,815 $110K
74181 210 177 $110K
73562 2,358 1,766 $109K
90710 9,866 9,177 $109K
86902 2,646 1,732 $106K
73080 4,886 3,827 $104K
80335 1,861 1,544 $104K
83001 2,671 2,397 $102K
83002 2,685 2,424 $102K
73552 4,473 3,417 $100K
90620 3,663 3,078 $100K
85730 10,110 7,878 $98K
80076 6,125 5,277 $95K
75561 187 142 $95K
86665 1,674 1,465 $94K
73100 4,624 3,324 $94K
82533 2,384 2,017 $93K
85610 14,350 11,137 $93K
90696 8,324 7,792 $91K
29075 605 533 $90K
77075 1,427 1,232 $90K
86923 4,339 2,766 $88K
0081A 928 876 $87K
95816 2,150 1,933 $86K
97001 2,887 2,318 $85K
86803 3,400 2,865 $85K
73140 4,578 3,652 $84K
87088 8,406 6,916 $82K
84450 8,442 7,444 $81K
72040 2,234 1,954 $81K
95812 692 640 $81K
72100 2,209 1,935 $80K
90688 8,750 8,245 $78K
82962 11,148 8,077 $76K
72156 159 118 $76K
87506 245 223 $76K
74183 63 43 $75K
73030 2,922 2,369 $75K
76882 4,801 2,729 $74K
82150 6,611 5,305 $72K
87799 1,623 1,041 $72K
72158 131 95 $71K
85660 6,130 2,133 $71K
93976 822 714 $70K
82550 5,911 4,902 $69K
82607 2,194 1,939 $69K
86900 11,911 8,089 $67K
88307 1,099 874 $66K
87081 5,893 5,385 $66K
76870 1,798 1,570 $65K
90671 6,437 4,806 $64K
93788 2,091 1,859 $64K
82043 5,174 4,657 $63K
0124A 1,091 980 $62K
87340 3,203 2,771 $62K
82810 2,856 1,035 $61K
87045 4,251 3,674 $61K
80074 545 502 $60K
83930 3,774 3,075 $60K
73070 3,365 2,522 $60K
80143 1,522 1,257 $58K
87483 148 114 $58K
86850 10,532 7,405 $58K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 1,406 923 $58K
73060 2,304 1,748 $57K
88304 2,216 1,827 $56K
72157 113 81 $56K
31541 286 240 $56K
86255 2,717 2,370 $55K
86706 2,667 2,289 $53K
80179 1,385 1,161 $53K
85007 11,976 7,972 $52K
82247 9,916 4,881 $52K
87150 126 25 $52K
0082A 528 518 $52K
0052A 675 432 $52K
92588 1,077 940 $52K
71045 Radiologic examination, chest; single view 3,601 2,813 $50K
86364 3,079 2,896 $50K
82105 2,031 1,678 $50K
31561 205 199 $48K
72070 1,448 1,277 $48K
43762 118 115 $48K
72195 89 77 $47K
20680 150 130 $47K
87205 7,068 5,116 $47K
87427 3,503 3,034 $46K
A9575 Injection, gadoterate meglumine, 0.1 ml 959 485 $46K
82010 2,516 1,666 $45K
82077 1,333 1,104 $45K
84480 1,416 1,286 $44K
0051A 606 395 $44K
93886 644 582 $44K
87529 856 661 $43K
85576 435 393 $42K
J9260 Injection, methotrexate sodium, 50 mg 2,235 1,103 $42K
91320 678 563 $42K
82570 4,470 3,636 $42K
71020 3,542 2,830 $41K
85384 3,225 2,245 $41K
86664 1,673 1,465 $41K
0054A 1,257 784 $40K
94664 7,996 6,575 $40K
90677 2,517 2,352 $39K
86147 331 313 $39K
87493 623 533 $39K
82610 1,270 1,163 $38K
J0586 Injection, abobotulinumtoxina, 5 units 19 12 $38K
42821 81 67 $38K
71555 57 50 $38K
88341 240 182 $36K
95713 83 74 $35K
74240 890 810 $35K
86663 1,674 1,466 $35K
87641 963 733 $35K
90656 2,199 1,965 $34K
86905 603 428 $34K
82009 3,577 3,122 $34K
80329 1,192 834 $34K
73120 1,659 1,218 $33K
51726 140 91 $33K
93296 1,043 901 $33K
82397 1,330 1,221 $33K
82024 1,027 915 $33K
73000 2,107 1,649 $33K
J1644 Injection, heparin sodium, per 1000 units 4,288 491 $33K
87015 3,788 2,473 $32K
83721 1,455 1,360 $31K
90732 1,302 806 $30K
31622 55 53 $30K
85018 6,404 3,934 $30K
82139 977 831 $29K
92582 4,314 3,854 $29K
80164 615 517 $29K
J0696 Injection, ceftriaxone sodium, per 250 mg 1,437 870 $29K
82565 3,645 2,801 $28K
70360 2,591 2,344 $28K
93242 1,883 1,480 $27K
0154A 607 550 $27K
70544 46 39 $25K
84156 3,647 2,862 $25K
84681 634 535 $24K
29345 77 75 $24K
92133 1,220 895 $24K
84550 3,330 2,681 $23K
92557 1,683 1,467 $23K
83525 1,311 1,176 $23K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 1,540 952 $22K
J3490 Unclassified drugs 852 492 $22K
80320 831 667 $21K
24538 75 63 $21K
93321 575 472 $21K
92250 1,650 1,282 $21K
86431 1,780 1,644 $20K
87210 2,798 2,151 $20K
84484 1,080 872 $19K
91319 472 406 $19K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 44 40 $19K
91318 747 693 $19K
82947 2,634 2,168 $19K
75565 201 155 $19K
73620 708 464 $18K
92524 354 318 $18K
87075 1,237 942 $18K
87329 1,250 1,052 $18K
87328 1,251 1,052 $18K
74241 438 371 $17K
92134 1,105 820 $17K
87505 95 88 $17K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 1,718 1,309 $17K
88720 6,287 2,749 $17K
82945 3,469 2,188 $17K
80051 1,330 981 $16K
86308 1,816 1,621 $16K
90713 1,416 1,266 $16K
93304 215 184 $16K
84157 3,470 2,188 $16K
84510 1,907 1,247 $16K
88312 608 541 $16K
71250 75 64 $16K
77076 494 432 $16K
74020 939 699 $15K
74270 260 235 $15K
86146 123 116 $15K
17250 27 26 $15K
92522 333 294 $14K
89230 1,143 973 $14K
83605 950 746 $14K
84075 1,989 1,674 $14K
J2250 Injection, midazolam hydrochloride, per 1 mg 922 580 $14K
92018 49 39 $14K
97003 584 487 $13K
J2704 Injection, propofol, 10 mg 7,292 5,068 $13K
86644 651 516 $13K
84030 1,911 1,249 $13K
92552 2,168 1,894 $13K
92586 510 458 $13K
84134 470 391 $13K
82270 2,896 2,395 $12K
73660 754 620 $12K
83655 1,242 1,134 $12K
90685 1,412 1,280 $12K
84520 1,945 1,620 $12K
90381 1,055 925 $12K
92650 525 449 $12K
J2545 Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg 355 263 $12K
84436 802 722 $12K
86945 719 331 $11K
86774 611 513 $11K
93243 68 33 $11K
92556 2,230 1,923 $11K
92235 282 210 $11K
94726 296 228 $10K
86481 229 181 $10K
75557 31 28 $10K
82438 1,832 858 $10K
54163 43 43 $10K
89051 1,273 916 $10K
86645 438 363 $10K
85240 472 377 $10K
J1815 Injection, insulin, per 5 units 59 41 $10K
76506 643 542 $9K
84132 1,456 1,110 $9K
93597 45 24 $9K
86648 475 402 $9K
90380 975 695 $9K
84702 540 442 $9K
85246 295 241 $9K
86231 513 481 $8K
76010 1,006 902 $8K
74000 656 517 $8K
92555 2,599 2,320 $8K
86353 68 52 $8K
84155 1,396 1,028 $8K
72110 141 131 $8K
81243 204 153 $8K
85014 2,157 1,406 $8K
87181 409 326 $7K
89050 1,638 999 $7K
53450 13 12 $7K
86704 383 290 $7K
85379 431 352 $7K
95811 47 36 $7K
99401 1,119 686 $7K
73600 192 155 $6K
49500 24 24 $6K
95715 22 15 $6K
84481 122 112 $6K
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,909 1,087 $6K
76937 271 223 $6K
95012 3,466 3,231 $6K
93308 96 81 $5K
30130 12 12 $5K
92585 201 157 $5K
0083A 135 131 $5K
85347 758 117 $5K
76499 246 120 $5K
76000 2,985 2,513 $5K
0202U Oncology (prostate), multianalyte, gene expression profiling 638 548 $5K
84403 185 156 $5K
86832 90 64 $4K
82746 133 116 $4K
J3010 Injection, fentanyl citrate, 0.1 mg 2,366 1,416 $4K
92553 483 397 $4K
75573 30 25 $4K
82310 460 367 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 856 592 $4K
80195 179 117 $4K
97165 29 27 $4K
93270 72 61 $4K
72080 152 123 $3K
90744 337 292 $3K
82670 121 110 $3K
94760 308 239 $3K
83021 134 119 $3K
0003A 64 62 $3K
83498 107 92 $3K
82340 259 241 $3K
85670 263 230 $3K
86985 464 325 $3K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 3,973 1,389 $3K
87807 209 189 $2K
86833 92 66 $2K
76604 80 65 $2K
84466 108 92 $2K
84295 379 253 $2K
86060 183 153 $2K
92583 712 632 $2K
D1351 Sealant - per tooth 85 26 $2K
D0120 Periodic oral evaluation - established patient 321 279 $2K
92083 569 461 $2K
95822 18 12 $2K
87110 63 59 $2K
90472 Immunization administration, each additional vaccine (list separately) 230 155 $2K
Q3014 Telehealth originating site facility fee 399 384 $2K
82140 104 88 $2K
92273 16 13 $2K
83520 242 169 $2K
81479 Unlisted molecular pathology procedure 69 32 $2K
86592 244 222 $1K
85245 39 27 $1K
D1208 Topical application of fluoride, excluding varnish 101 82 $1K
84311 212 179 $1K
92595 758 690 $1K
85335 71 67 $1K
45380 Colonoscopy, flexible; with biopsy, single or multiple 39 35 $1K
87116 122 75 $1K
71010 228 158 $1K
88313 39 29 $1K
82374 237 153 $1K
D1110 Prophylaxis - adult 157 136 $1K
J1720 Injection, hydrocortisone sodium succinate, up to 100 mg 342 235 $1K
86708 63 53 $1K
89055 198 160 $1K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 274 183 $997.80
87101 126 108 $994.52
87102 94 75 $976.92
72050 12 12 $935.83
88311 43 38 $912.26
93280 16 13 $888.60
93971 15 12 $876.00
86235 101 88 $799.52
92591 163 150 $784.62
73092 34 26 $773.92
84478 69 50 $752.87
16020 35 29 $734.41
74455 283 246 $730.83
82627 30 25 $720.02
84402 34 27 $690.84
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 16 12 $688.59
86787 41 40 $679.14
J0834 Injection, cosyntropin, 0.25 mg 13 12 $672.94
86940 72 52 $668.00
84244 27 25 $659.61
87498 22 13 $658.71
90999 Unlisted dialysis procedure, inpatient or outpatient 340 12 $620.00
87653 21 13 $608.04
87532 21 13 $601.44
87496 21 13 $601.44
87425 53 45 $595.53
84210 45 40 $589.38
87206 118 74 $587.06
85250 13 12 $553.59
86038 179 151 $517.33
86039 169 152 $507.90
90630 24 23 $496.63
88350 25 16 $446.82
J1885 Injection, ketorolac tromethamine, per 15 mg 45 29 $437.51
99402 23 18 $429.00
90672 18 18 $417.96
92551 99 87 $374.47
86880 30 28 $319.84
83090 13 13 $313.17
86225 94 79 $264.68
84446 82 67 $253.75
V5275 Ear impression, each 156 151 $245.50
84590 76 60 $213.64
80158 19 13 $193.22
87147 34 26 $192.14
82085 58 46 $152.57
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 13 12 $151.97
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 15 12 $142.73
92593 104 85 $142.21
90649 16 14 $133.84
88346 25 16 $127.38
A9539 Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries 23 12 $123.12
83935 17 13 $116.76
82542 13 12 $109.13
92558 1,795 1,598 $104.16
92594 389 356 $99.02
87209 15 12 $94.92
82465 19 13 $80.86
82379 25 12 $79.28
94799 39 27 $71.60
86317 35 30 $65.64
87522 Neg quan hep c or qual rna 25 20 $51.17
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 157 147 $43.50
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 184 177 $43.50
85008 85 56 $41.54
87177 15 12 $38.13
87338 32 26 $31.69
J2919 Injection, methylprednisolone sodium succinate, 5 mg 20 13 $25.91
96112 738 686 $24.11
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 66 43 $8.77
76001 95 56 $0.00
D0330 Panoramic radiographic image 20 16 $0.00
93319 174 147 $0.00
A9999 Miscellaneous dme supply or accessory, not otherwise specified 234 179 $0.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 44 41 $0.00
80301 242 191 $0.00
A6250 Skin sealants, protectants, moisturizers, ointments, any type, any size 54 41 $0.00
99215 Prolong outpt/office vis 13 13 $0.00
A4550 Surgical trays 273 192 $0.00
A7046 Water chamber for humidifier, used with positive airway pressure device, replacement, each 348 325 $0.00
A4245 Alcohol wipes, per box 13 13 $0.00
76981 50 41 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 16 12 $0.00
92622 37 36 $0.00
D0220 Intraoral - periapical first radiographic image 46 40 $0.00
A7003 Administration set, with small volume nonfiltered pneumatic nebulizer, disposable 12 12 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 21 21 $0.00
D8690 33 29 $0.00
D2930 Prefabricated stainless steel crown - primary tooth 42 39 $0.00
A4663 Blood pressure cuff only 72 69 $0.00
D1120 Prophylaxis - child 149 132 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 25 22 $0.00
51784 14 13 $0.00
D0274 Bitewings - four radiographic images 44 40 $0.00
92592 14 13 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 42 36 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 20 18 $0.00
A4461 Surgical dressing holder, non-reusable, each 296 213 $0.00
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 21 20 $0.00
92228 200 193 $0.00
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 35 32 $0.00
80304 46 46 $0.00
E1399 Durable medical equipment, miscellaneous 556 379 $0.00
92590 47 42 $0.00
B4088 Gastrostomy/jejunostomy tube, low-profile, any material, any type, each 459 414 $0.00
A6222 Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing 125 75 $0.00
A4215 Needle, sterile, any size, each 135 103 $0.00
A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply 263 241 $0.00
J7060 5% dextrose/water (500 ml = 1 unit) 47 20 $0.00
J7050 Infusion, normal saline solution, 250 cc 463 348 $0.00
D0140 Limited oral evaluation - problem focused 139 129 $0.00
99381 130 99 $0.00
D1206 Topical application of fluoride varnish 201 181 $0.00
D7140 Extraction, erupted tooth or exposed root 38 36 $0.00
D0230 Intraoral - periapical each additional radiographic image 37 34 $0.00
86769 55 50 $0.00
D2330 18 16 $0.00
93246 14 13 $0.00
E0602 Breast pump, manual, any type 28 15 $0.00
J7042 5% dextrose/normal saline (500 ml = 1 unit) 60 47 $0.00
D0150 Comprehensive oral evaluation - new or established patient 23 21 $0.00
D2335 16 14 $0.00
A7015 Aerosol mask, used with dme nebulizer 12 12 $0.00