Medicaid Provider Spending

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

PROSPECT MANCHESTER HOSPITAL, INC.

NPI: 1316394638 · MANCHESTER, CT 06040 · Emergency Care Clinic/Center · NPI assigned 05/17/2016

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

Authorized official ELDERS, ROBERT controls 20+ related entities in our dataset. Read more

$69.20M
Total Medicaid Paid
2,197,712
Total Claims
1,729,624
Beneficiaries
410
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialELDERS, ROBERT (SECRETARY)
NPI Enumeration Date05/17/2016

Related Entities

Other providers sharing the same authorized official: ELDERS, ROBERT

ProviderCityStateTotal Paid
PROSPECT WATERBURY, INC. WATERBURY CT $84.62M
PROSPECT CHARTERCARE RWMC, LLC PROVIDENCE RI $57.10M
PROSPECT CCMC, LLC CHESTER PA $40.89M
PROSPECT CT MEDICAL FOUNDATION, INC. MANCHESTER CT $34.07M
PROSPECT ROCKVILLE HOSPITAL, INC. VERNON CT $30.06M
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $10.94M
PROSPECT DCMH, LLC DREXEL HILL PA $10.37M
PROSPECT CCMC, LLC CHESTER PA $5.46M
ALTA LOS ANGELES HOSPITALS, INC. LOS ANGELES CA $5.42M
PROSPECT CCMC, LLC CHESTER PA $5.03M
PROSPECT CCMC, LLC CHESTER PA $3.71M
PROSPECT CHARTERCARE PHYSICIANS, LLC CRANSTON RI $2.31M
PROSPECT ECHN HOME HEALTH, INC. VERNON CT $1.75M
PROSPECT WATERBURY HOME HEALTH, INC. WATERTOWN CT $1.30M
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $1.22M
ALTA NEWPORT HOSPITAL, LLC TUSTIN CA $1.16M
PROSPECT HEALTH ACCESS NETWORK, INC. CRUM LYNNE PA $924K
PROSPECT HEALTH ACCESS NETWORK, INC. CHESTER PA $872K
PROSPECT CHARTERCARE SJHSRI, LLC NORTH PROVIDENCE RI $858K
PROSPECT HEALTH ACCESS NETWORK, INC. DREXEL HILL PA $815K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 362,426 $11.01M
2019 340,396 $11.66M
2020 285,286 $8.80M
2021 319,045 $9.70M
2022 311,067 $9.74M
2023 285,830 $9.63M
2024 293,662 $8.66M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G0384 Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 17,694 15,740 $10.17M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 19,599 16,960 $6.67M
99284 Emergency department visit for the evaluation and management, high severity 17,616 15,448 $4.02M
G0383 Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 16,689 15,504 $3.75M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 23,540 20,245 $3.40M
99283 Emergency department visit for the evaluation and management, moderate severity 18,924 16,808 $3.23M
G0382 Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 16,818 15,603 $2.84M
45380 Colonoscopy, flexible; with biopsy, single or multiple 2,952 2,815 $2.09M
74177 Computed tomography, abdomen and pelvis; with contrast material 8,427 7,801 $1.93M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 4,427 4,196 $1.89M
G0379 Direct admission of patient for hospital observation care 2,766 2,207 $1.44M
S9480 Intensive outpatient psychiatric services, per diem 10,546 1,784 $1.36M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 34,757 10,775 $1.24M
90834 Psychotherapy, 45 minutes with patient 23,539 14,590 $991K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 16,240 15,226 $977K
95810 Polysomnography; sleep staging with 4 or more additional parameters 1,246 1,209 $957K
70450 Computed tomography, head or brain; without contrast material 9,295 8,431 $933K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 7,348 4,435 $816K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,638 1,541 $776K
96375 Therapeutic injection; each additional sequential IV push 16,941 13,789 $756K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 4,833 2,213 $754K
71046 Radiologic examination, chest; 2 views 13,902 12,392 $741K
96361 Intravenous infusion, hydration; each additional hour 13,657 10,550 $699K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 18,998 6,643 $692K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 1,578 1,449 $672K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 824 753 $661K
H0035 Mental health partial hospitalization, treatment, less than 24 hours 2,941 517 $574K
74176 Computed tomography, abdomen and pelvis; without contrast material 3,483 3,251 $510K
97597 6,382 3,096 $504K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 3,788 3,323 $474K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 7,878 6,071 $471K
71045 Radiologic examination, chest; single view 8,891 7,895 $429K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 4,332 4,050 $421K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 10,816 9,766 $413K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 2,040 1,911 $413K
H0015 Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education 2,962 548 $386K
97010 20,537 6,661 $367K
99282 Emergency department visit for the evaluation and management, low to moderate severity 2,783 2,565 $306K
84443 Thyroid stimulating hormone (TSH) 29,213 27,595 $287K
80053 Comprehensive metabolic panel 41,213 36,868 $271K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 103,510 84,703 $266K
97161 4,578 4,219 $254K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 12,808 12,326 $253K
90832 Psychotherapy, 30 minutes with patient 8,839 6,303 $242K
80061 Lipid panel 26,805 25,741 $238K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 14,251 10,964 $228K
71275 Computed tomographic angiography, chest, with contrast material 1,861 1,711 $213K
G0381 Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 2,205 2,108 $211K
90792 Psychiatric diagnostic evaluation with medical services 1,768 1,680 $206K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 2,170 2,030 $206K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 7,996 7,557 $199K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 7,995 7,556 $199K
59025 Fetal non-stress test 1,790 1,404 $193K
76705 Ultrasound, abdominal, real time with image documentation; limited 2,205 2,057 $185K
97035 10,248 3,830 $184K
90853 Group psychotherapy (other than of a multiple-family group) 12,037 3,473 $171K
J3380 Injection, vedolizumab, intravenous, 1 mg 39 36 $170K
77067 Screening mammography, bilateral, including computer-aided detection 1,424 1,401 $162K
93971 2,206 2,065 $149K
36415 Collection of venous blood by venipuncture 161,638 113,447 $142K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 10,529 10,323 $139K
86900 5,978 5,196 $136K
83036 Hemoglobin; glycosylated (A1C) 21,662 20,783 $129K
76830 Ultrasound, transvaginal 1,444 1,344 $129K
G0380 Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 1,699 1,596 $128K
93798 1,968 291 $127K
76700 Ultrasound, abdominal, real time with image documentation; complete 1,311 1,268 $124K
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 2,100 1,818 $118K
76801 1,127 1,002 $114K
82947 45,946 39,030 $112K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 188 173 $110K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,288 1,230 $108K
71250 2,070 1,979 $107K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 3,850 3,705 $104K
97162 2,229 2,076 $103K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 349 318 $96K
97012 1,861 676 $95K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 2,316 1,043 $94K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 2,899 2,488 $93K
82728 9,732 9,191 $86K
97014 3,280 1,406 $83K
97113 1,931 576 $82K
80048 Basic metabolic panel (calcium, ionized) 15,428 11,991 $70K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 4,866 4,633 $68K
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 9,296 6,867 $65K
93970 499 467 $61K
82607 6,405 6,120 $60K
95811 94 90 $56K
90791 Psychiatric diagnostic evaluation 534 488 $56K
87086 Culture, bacterial; quantitative colony count, urine 17,372 15,589 $51K
83550 8,101 7,777 $47K
86780 4,238 4,036 $46K
72125 Computed tomography, cervical spine; without contrast material 2,919 2,661 $45K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 1,509 1,037 $40K
84153 3,363 3,239 $40K
83540 8,962 8,567 $39K
86803 3,806 3,654 $38K
82746 4,004 3,815 $37K
84439 6,338 6,027 $36K
86885 3,108 2,701 $35K
78815 Positron emission tomography (PET) for limited area imaging 73 72 $33K
97530 Therapeutic activities, direct patient contact, each 15 minutes 1,087 702 $31K
73630 3,051 2,656 $30K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 6,614 3,848 $30K
97165 448 423 $30K
83615 8,781 6,716 $29K
93017 1,869 1,738 $28K
43450 110 106 $27K
86617 1,348 1,255 $27K
70486 800 753 $27K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 11,257 10,031 $26K
83735 18,283 15,197 $25K
72100 2,139 2,000 $25K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 99 92 $24K
73564 2,144 1,849 $24K
82784 2,002 1,881 $24K
97535 Self-care/home management training, each 15 minutes 1,204 769 $23K
G0378 Hospital observation service, per hour 9,785 7,970 $23K
85027 9,418 7,920 $23K
87070 7,353 6,701 $21K
72110 366 351 $21K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 244 233 $21K
10060 133 118 $21K
82570 8,377 7,092 $20K
73030 2,708 2,424 $20K
70496 124 121 $19K
85610 16,448 12,246 $19K
99215 Prolong outpt/office vis 174 152 $19K
87340 3,369 3,189 $18K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 23,588 20,622 $18K
76642 317 264 $18K
98968 372 219 $17K
82043 4,885 4,741 $17K
62323 65 64 $17K
87186 5,933 5,463 $16K
11043 57 28 $16K
84403 789 753 $16K
83970 887 856 $16K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 105 99 $16K
99281 Emergency department visit for the evaluation and management, self-limited or minor 271 234 $15K
80076 3,367 2,722 $15K
86038 1,635 1,562 $14K
70551 Magnetic resonance imaging, brain; without contrast material 181 168 $14K
98967 326 204 $13K
76536 186 177 $13K
87493 706 663 $12K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 626 558 $12K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 45 41 $12K
94060 59 58 $12K
74018 602 543 $11K
73610 2,287 2,095 $11K
84702 3,595 2,953 $11K
83883 744 694 $11K
86140 4,380 3,965 $10K
73130 1,880 1,660 $10K
86666 642 597 $10K
85007 7,466 6,146 $10K
86704 1,036 990 $10K
76775 242 232 $10K
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 2,178 2,043 $9K
81001 19,373 17,430 $9K
83690 22,286 19,436 $9K
73502 1,271 1,183 $9K
87625 903 879 $8K
86403 2,371 2,201 $8K
73562 1,340 1,129 $8K
86334 720 675 $8K
83880 5,713 5,151 $8K
87077 3,170 2,907 $8K
73110 1,275 1,153 $8K
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 6,904 4,988 $8K
85652 5,570 4,968 $8K
84146 685 652 $7K
97116 358 259 $7K
87660 619 582 $7K
87480 619 582 $7K
87510 619 582 $7K
82652 244 236 $7K
84165 1,169 1,099 $7K
83516 422 394 $6K
86618 1,057 991 $6K
86753 542 504 $6K
86480 142 137 $6K
84402 299 281 $6K
80051 46,388 39,286 $6K
87205 3,833 3,453 $6K
82565 48,010 40,664 $5K
80069 1,294 1,141 $5K
86696 328 317 $5K
86787 1,313 1,229 $5K
86762 1,509 1,418 $5K
71271 44 44 $5K
88342 5,655 4,406 $5K
84100 3,685 2,918 $5K
80164 783 685 $5K
82378 426 369 $5K
85730 4,232 3,729 $5K
88142 354 345 $5K
82150 887 727 $4K
90837 Psychotherapy, 53 minutes with patient 51 41 $4K
82105 335 322 $4K
82247 38,030 32,581 $4K
87522 Neg quan hep c or qual rna 149 138 $4K
72072 182 169 $4K
82950 1,000 963 $4K
86431 994 959 $4K
70491 26 26 $4K
83013 77 71 $4K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 6,113 3,832 $4K
84450 39,283 33,896 $4K
87427 586 548 $4K
86695 328 317 $4K
90847 Family psychotherapy with the patient present, 50 minutes 49 38 $3K
84550 2,451 2,212 $3K
84160 1,168 1,099 $3K
83655 303 295 $3K
87081 691 650 $3K
82550 2,168 1,912 $3K
J3490 Unclassified drugs 100,885 41,308 $3K
83001 204 195 $3K
87045 586 548 $3K
87046 586 548 $3K
82248 2,024 1,598 $3K
85045 1,246 1,126 $2K
86376 257 246 $2K
84703 1,303 1,222 $2K
84630 230 202 $2K
P9016 Red blood cells, leukocytes reduced, each unit 17 12 $2K
73700 45 40 $2K
87177 360 334 $2K
82977 501 476 $2K
85379 4,513 4,153 $2K
73140 392 362 $2K
83721 333 320 $2K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 13 12 $2K
82310 7,341 6,624 $2K
82172 242 236 $2K
84156 1,289 1,075 $2K
82140 602 480 $2K
70498 131 128 $2K
72131 62 57 $2K
84484 16,149 13,359 $2K
73080 382 348 $2K
77065 Tomosynthesis, mammo 12 12 $2K
88305 Level IV - Surgical pathology, gross and microscopic examination 11,537 7,228 $1K
87040 2,846 2,504 $1K
81003 986 890 $1K
29515 16 12 $1K
86328 52 51 $1K
91065 12 12 $1K
84520 47,207 39,960 $1K
85014 1,243 1,024 $1K
85018 1,243 1,024 $1K
82040 37,274 32,119 $1K
86316 84 74 $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 80 26 $1K
83002 67 63 $990.08
81025 16,194 14,524 $975.36
72050 13 13 $956.24
82670 43 39 $933.80
86706 119 114 $933.66
84075 37,236 32,128 $922.15
87536 13 12 $893.86
93880 13 12 $865.32
81002 19,899 17,871 $822.42
87328 99 93 $778.60
87329 99 93 $778.60
88112 65 55 $777.88
84481 56 56 $725.16
71101 305 286 $723.49
72040 66 63 $677.32
84145 1,897 1,603 $648.08
97163 12 12 $641.34
86003 12 12 $632.46
87430 123 114 $584.92
80178 178 143 $523.73
96376 6,016 4,121 $523.63
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,107 986 $516.81
84207 27 26 $515.90
83605 4,869 4,236 $515.82
82553 1,597 1,224 $510.30
82270 256 231 $508.64
83525 55 54 $501.86
84460 39,344 33,953 $479.42
83014 77 71 $458.11
86800 39 39 $429.66
82785 43 39 $427.40
97124 107 65 $401.19
86200 40 37 $395.52
U0001 Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel 13 12 $395.01
86747 540 496 $373.36
84436 136 131 $355.91
76870 26 25 $348.63
86765 34 31 $337.51
12011 68 66 $325.50
12001 688 653 $299.03
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,883 1,662 $284.65
82533 24 24 $280.26
86308 113 109 $266.76
97032 61 28 $254.96
84425 12 12 $243.24
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 13,920 12,742 $241.02
84155 36,930 31,805 $239.66
J7030 Infusion, normal saline solution , 1000 cc 19,751 15,748 $227.46
73090 51 51 $227.04
90714 1,674 1,566 $224.10
J2405 Injection, ondansetron hydrochloride, per 1 mg 18,395 14,330 $215.01
87420 209 197 $206.10
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,337 2,148 $184.90
86735 16 14 $161.98
73590 123 108 $160.47
J1885 Injection, ketorolac tromethamine, per 15 mg 16,814 14,064 $125.48
83021 26 24 $120.68
94761 4,215 3,749 $113.48
88304 784 713 $111.05
83921 13 13 $110.04
96367 15 12 $104.84
73560 21 12 $98.72
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 216 195 $81.42
86901 5,978 5,196 $80.80
85049 173 141 $74.80
82948 4,498 3,443 $69.76
88313 6,290 4,239 $64.65
84132 36 36 $64.09
94760 2,851 2,555 $63.25
J1170 Injection, hydromorphone, up to 4 mg 7,863 4,160 $52.35
J0696 Injection, ceftriaxone sodium, per 250 mg 5,256 2,659 $47.10
87207 59 59 $43.23
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 2,168 1,897 $41.78
36416 5,319 4,057 $36.75
86850 2,033 1,862 $34.40
J1650 Injection, enoxaparin sodium, 10 mg 931 532 $25.23
J1100 Injection, dexamethasone sodium phosphate, 1 mg 5,420 4,823 $15.76
87210 499 470 $13.83
J7120 Ringers lactate infusion, up to 1000 cc 3,043 2,198 $11.00
J2060 Injection, lorazepam, 2 mg 3,716 2,671 $9.17
81015 43 39 $8.27
J2270 Injection, morphine sulfate, up to 10 mg 7,344 4,821 $7.96
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 1,213 1,019 $2.69
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 528 425 $2.53
G0103 Prostate cancer screening; prostate specific antigen test (psa) 12 12 $2.16
J7050 Infusion, normal saline solution, 250 cc 5,749 3,859 $2.15
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 435 359 $2.08
A9150 Non-prescription drugs 2,324 1,810 $1.97
J1200 Injection, diphenhydramine hcl, up to 50 mg 4,073 2,895 $1.74
J2765 Injection, metoclopramide hcl, up to 10 mg 3,043 2,617 $1.48
J2550 Injection, promethazine hcl, up to 50 mg 2,353 1,567 $0.82
J3010 Injection, fentanyl citrate, 0.1 mg 7,747 5,812 $0.73
J8499 Prescription drug, oral, non chemotherapeutic, nos 2,936 2,135 $0.58
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 147 121 $0.50
C9113 Injection, pantoprazole sodium, per vial 1,407 851 $0.46
J3475 Injection, magnesium sulfate, per 500 mg 772 447 $0.09
J1644 Injection, heparin sodium, per 1000 units 3,084 1,392 $0.00
A9575 Injection, gadoterate meglumine, 0.1 ml 913 854 $0.00
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 86 85 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 102 91 $0.00
94729 29 28 $0.00
29125 102 94 $0.00
J0171 Injection, adrenalin, epinephrine, 0.1 mg 458 341 $0.00
97598 2,126 642 $0.00
J1956 Injection, levofloxacin, 250 mg 59 26 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 229 161 $0.00
82075 323 277 $0.00
93356 224 214 $0.00
93041 246 221 $0.00
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 135 78 $0.00
99442 227 186 $0.00
82800 15 13 $0.00
J1171 Injection, hydromorphone, 0.1 mg 223 89 $0.00
J3370 Injection, vancomycin hcl, 500 mg 73 36 $0.00
S0164 Injection, pantoprazole sodium, 40 mg 26 15 $0.00
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 26 25 $0.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 95 71 $0.00
Q0243 Injection, casirivimab and imdevimab, 2400 mg 85 81 $0.00
82009 14 12 $0.00
94727 29 28 $0.00
88312 16 16 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 2,994 2,581 $0.00
J2785 Injection, regadenoson, 0.1 mg 947 881 $0.00
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 1,637 1,531 $0.00
J1630 Injection, haloperidol, up to 5 mg 818 645 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 1,789 498 $0.00
97802 591 517 $0.00
J0690 Injection, cefazolin sodium, 500 mg 3,402 2,785 $0.00
J1815 Injection, insulin, per 5 units 1,450 660 $0.00
J2704 Injection, propofol, 10 mg 13,516 10,864 $0.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 1,982 1,671 $0.00
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg 856 739 $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 1,847 1,529 $0.00
A9270 Non-covered item or service 2,573 1,001 $0.00
J3535 Drug administered through a metered dose inhaler 154 143 $0.00
J0500 Injection, dicyclomine hcl, up to 20 mg 202 180 $0.00
96368 119 68 $0.00
88307 66 53 $0.00
J0131 Injection, acetaminophen, not otherwise specified,10 mg 132 106 $0.00
J7042 5% dextrose/normal saline (500 ml = 1 unit) 23 13 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 234 146 $0.00
A9585 Injection, gadobutrol, 0.1 ml 138 132 $0.00
J7060 5% dextrose/water (500 ml = 1 unit) 140 93 $0.00
J8540 Dexamethasone, oral, 0.25 mg 160 143 $0.00
12002 88 80 $0.00
88341 14 12 $0.00
C1781 Mesh (implantable) 52 50 $0.00
J1790 Injection, droperidol, up to 5 mg 148 127 $0.00
11045 168 38 $0.00
99070 46 29 $0.00
77001 20 13 $0.00
74019 13 12 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 12 12 $0.00
86920 17 12 $0.00