Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › CT › MERIDEN › MIDSTATE MEDICAL CENTER

MIDSTATE MEDICAL CENTER

NPI: 1427007848 · MERIDEN, CT 06451 · Emergency Care Clinic/Center · NPI assigned 05/10/2006

$110.82M
Total Medicaid Paid
2,176,560
Total Claims
1,613,246
Beneficiaries
425
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBOISVERT, GERALD (VP CFO)
NPI Enumeration Date05/10/2006

Related Entities

Other providers sharing the same authorized official: BOISVERT, GERALD

ProviderCityStateTotal Paid
HARTFORD HOSPITAL HARTFORD CT $16K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 313,284 $15.16M
2019 302,413 $15.36M
2020 274,768 $12.57M
2021 326,509 $16.62M
2022 331,750 $17.23M
2023 321,150 $17.06M
2024 306,686 $16.81M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 51,849 43,486 $26.79M
99284 Emergency department visit for the evaluation and management, high severity 59,523 51,528 $17.12M
99283 Emergency department visit for the evaluation and management, moderate severity 48,440 42,401 $9.97M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 97,092 82,197 $9.78M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 34,873 29,493 $5.13M
74177 Computed tomography, abdomen and pelvis; with contrast material 12,146 10,787 $2.53M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 5,836 5,422 $2.43M
45380 Colonoscopy, flexible; with biopsy, single or multiple 3,226 2,980 $2.22M
96361 Intravenous infusion, hydration; each additional hour 31,753 25,350 $1.77M
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 12,529 5,048 $1.76M
95810 Polysomnography; sleep staging with 4 or more additional parameters 3,166 2,907 $1.34M
71046 Radiologic examination, chest; 2 views 22,868 20,465 $1.31M
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 20,292 17,438 $1.29M
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 8,984 7,878 $1.20M
96375 Therapeutic injection; each additional sequential IV push 25,360 20,350 $1.17M
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 10,632 8,790 $1.12M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 39,690 38,588 $1.03M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 8,464 5,888 $1.00M
99282 Emergency department visit for the evaluation and management, low to moderate severity 7,776 7,116 $944K
95811 2,158 1,950 $907K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 21,468 20,588 $905K
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 11,200 9,977 $903K
70450 Computed tomography, head or brain; without contrast material 13,129 11,489 $764K
74176 Computed tomography, abdomen and pelvis; without contrast material 5,127 4,608 $718K
77067 Screening mammography, bilateral, including computer-aided detection 6,694 6,419 $706K
47562 161 147 $647K
71045 Radiologic examination, chest; single view 13,018 11,399 $643K
93975 3,125 2,779 $640K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 1,201 933 $602K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 1,987 1,761 $595K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 5,545 5,242 $591K
72125 Computed tomography, cervical spine; without contrast material 4,561 4,012 $582K
11043 3,021 1,525 $533K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 1,140 1,069 $505K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 2,918 1,244 $498K
59025 Fetal non-stress test 2,804 1,897 $446K
27447 297 237 $437K
76641 4,549 4,249 $397K
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 18,580 16,071 $393K
76830 Ultrasound, transvaginal 3,277 3,016 $334K
76700 Ultrasound, abdominal, real time with image documentation; complete 3,457 3,241 $327K
77065 Tomosynthesis, mammo 3,112 2,714 $320K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 3,309 3,031 $314K
52356 93 78 $282K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1,935 1,755 $278K
77066 Tomosynthesis, mammo 2,321 2,117 $264K
71275 Computed tomographic angiography, chest, with contrast material 2,040 1,858 $254K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,043 913 $252K
90791 Psychiatric diagnostic evaluation 6,277 5,234 $233K
76642 3,495 3,218 $212K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,587 1,402 $202K
93971 2,903 2,653 $193K
76705 Ultrasound, abdominal, real time with image documentation; limited 2,219 2,031 $192K
J1439 Injection, ferric carboxymaltose, 1 mg 419 246 $186K
76801 1,774 1,487 $178K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 964 863 $175K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 4,162 3,812 $169K
70551 Magnetic resonance imaging, brain; without contrast material 1,369 1,203 $168K
76770 1,991 1,851 $162K
10060 951 870 $152K
58558 83 79 $149K
27130 78 65 $146K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 340 318 $134K
74183 653 600 $130K
72110 3,516 3,271 $115K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 3,455 2,159 $102K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 7,264 7,051 $99K
77063 Screening digital breast tomosynthesis, bilateral 6,400 6,136 $91K
73564 4,776 4,354 $86K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 2,474 2,239 $85K
78815 Positron emission tomography (PET) for limited area imaging 139 132 $85K
72141 482 414 $77K
97597 1,115 686 $76K
Q0138 Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) 276 158 $74K
86900 5,834 5,051 $71K
0001A 2,287 2,124 $71K
70496 520 467 $69K
0002A 2,140 2,006 $69K
99232 Subsequent hospital care, per day, moderate complexity 3,599 1,487 $64K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 718 626 $63K
71250 1,347 1,223 $63K
97161 2,697 2,227 $58K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,450 1,365 $56K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 44,688 37,233 $53K
73221 277 243 $50K
93970 361 334 $49K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 10,611 7,932 $43K
99233 Prolong inpt eval add15 m 1,611 744 $43K
96367 1,076 594 $40K
72050 620 577 $39K
74018 2,722 2,295 $34K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 2,126 1,731 $34K
76536 424 392 $33K
19083 27 26 $31K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 3,703 3,348 $30K
88305 Level IV - Surgical pathology, gross and microscopic examination 11,534 10,494 $30K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 3,704 3,350 $30K
73030 3,750 3,337 $30K
99223 Prolong inpt eval add15 m 547 522 $28K
74220 283 267 $27K
62323 80 77 $26K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 215 186 $25K
73630 4,357 4,012 $25K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 92,768 71,244 $25K
20553 344 307 $24K
J2469 Injection, palonosetron hcl, 25 mcg 246 116 $24K
36561 12 12 $24K
10061 67 64 $23K
80053 Comprehensive metabolic panel 75,647 60,448 $23K
99239 Hospital discharge day management, more than 30 minutes 711 687 $22K
96415 499 280 $21K
93798 389 48 $21K
97116 1,501 911 $21K
73502 2,427 2,090 $20K
73130 3,392 3,097 $19K
43235 52 52 $19K
70486 1,116 997 $19K
97162 796 665 $19K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 169 156 $19K
73110 2,632 2,338 $19K
74019 954 868 $18K
72131 518 476 $17K
0202U Oncology (prostate), multianalyte, gene expression profiling 46 43 $17K
96417 508 225 $17K
77336 330 108 $17K
99281 Emergency department visit for the evaluation and management, self-limited or minor 253 220 $16K
73610 4,198 3,852 $16K
77334 73 39 $13K
93017 247 222 $13K
G0498 Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion 110 43 $12K
99231 Subsequent hospital care, per day, straightforward or low complexity 1,135 403 $12K
76813 134 120 $12K
99222 Initial hospital care, per day, moderate complexity 269 261 $11K
72040 538 455 $11K
J0185 Injection, aprepitant, 1 mg 120 57 $11K
99254 119 115 $11K
88342 2,583 2,343 $11K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 427 407 $11K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 3,950 3,642 $10K
76857 108 105 $10K
70491 59 54 $9K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 406 375 $9K
0031A 423 293 $9K
97165 227 208 $8K
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk 13 13 $8K
82728 1,310 1,189 $8K
J0897 Injection, denosumab, 1 mg 13 12 $8K
72197 13 13 $7K
73140 2,023 1,835 $7K
78264 24 24 $7K
72158 28 25 $7K
72100 228 209 $7K
76970 64 61 $6K
G0378 Hospital observation service, per hour 10,792 7,023 $6K
73080 1,282 1,156 $6K
M0245 Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring 21 16 $6K
91040 28 26 $6K
76870 183 165 $6K
36415 Collection of venous blood by venipuncture 22,278 15,666 $6K
72070 164 155 $6K
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography 29 27 $5K
0011A 185 178 $5K
J1442 Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram 74 12 $5K
29515 49 40 $5K
83550 1,249 1,135 $5K
73560 649 552 $5K
78226 27 19 $5K
0012A 172 156 $5K
96411 150 77 $5K
12001 1,708 1,558 $4K
97530 Therapeutic activities, direct patient contact, each 15 minutes 470 320 $4K
95806 53 46 $4K
73700 111 98 $4K
83540 1,259 1,141 $4K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 11,013 9,533 $4K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 34,402 29,710 $4K
92610 58 52 $4K
43450 14 13 $3K
99253 68 44 $3K
74240 28 27 $3K
0064A 77 77 $3K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 10,055 9,258 $3K
72081 29 29 $3K
93308 13 13 $2K
97535 Self-care/home management training, each 15 minutes 115 87 $2K
70498 483 441 $2K
80048 Basic metabolic panel (calcium, ionized) 16,019 12,655 $2K
0004A 57 57 $2K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 8,909 7,126 $2K
95816 13 13 $2K
73590 625 561 $2K
J1447 Injection, tbo-filgrastim, 1 microgram 40 12 $2K
88184 14 14 $2K
99241 60 57 $2K
93880 14 14 $2K
74181 13 13 $2K
74174 15 12 $2K
83735 21,457 16,772 $2K
82378 326 268 $2K
71100 380 357 $2K
76882 24 24 $1K
83036 Hemoglobin; glycosylated (A1C) 2,558 2,260 $1K
85610 14,567 10,996 $1K
80061 Lipid panel 231 205 $1K
83615 1,377 1,055 $1K
82784 206 185 $1K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 2,368 2,210 $1K
93976 16 16 $1K
85379 4,193 3,805 $1K
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 11,613 9,724 $1K
84443 Thyroid stimulating hormone (TSH) 2,467 2,146 $983.80
81025 26,717 23,389 $948.32
82607 162 150 $863.40
85730 2,272 1,961 $824.12
73090 274 249 $813.90
84703 2,705 2,478 $793.12
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 366 314 $777.27
71101 112 108 $736.48
83883 90 71 $723.88
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 1,789 1,054 $649.02
0054A 16 16 $600.00
73660 52 50 $586.11
90686 62 51 $570.90
86780 56 52 $568.80
99242 23 13 $516.24
84484 31,180 21,632 $494.83
0003A 14 14 $480.00
36591 16 14 $479.72
87641 282 246 $468.01
87086 Culture, bacterial; quantitative colony count, urine 13,696 12,000 $463.27
97150 Therapeutic procedure(s), group (2 or more individuals) 396 294 $457.13
85045 274 242 $445.89
83690 26,528 22,671 $442.38
83880 5,469 4,818 $440.33
87077 7,967 7,061 $379.04
85652 1,646 1,442 $374.55
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 36 24 $358.60
72170 128 105 $350.88
88360 64 57 $348.60
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 5,695 5,305 $322.53
86850 5,120 4,445 $306.72
90715 3,448 3,099 $291.11
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,436 2,139 $277.22
82962 29,993 14,930 $247.73
87186 5,037 4,442 $246.30
81001 10,587 9,170 $235.40
86901 5,842 5,051 $224.37
81003 30,271 26,106 $218.37
83605 7,985 6,116 $196.31
29125 272 247 $192.22
84702 3,447 2,860 $181.63
86140 605 545 $161.71
96376 6,569 4,972 $157.22
73060 15 12 $138.30
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 18,577 16,255 $131.59
82803 1,230 1,009 $121.10
87070 5,814 5,017 $118.25
J3490 Unclassified drugs 288,458 84,505 $118.06
88304 1,904 1,715 $115.47
99449 12 12 $109.20
93356 192 179 $106.10
80076 2,679 2,308 $102.06
87040 7,994 3,785 $101.79
82746 14 12 $98.28
J7030 Infusion, normal saline solution , 1000 cc 47,155 34,380 $93.72
84165 18 16 $92.34
87400 2,898 2,671 $91.60
82550 6,581 5,510 $90.93
85027 3,048 2,133 $84.66
87081 2,964 2,798 $67.63
69209 147 135 $60.54
82077 767 699 $56.18
81002 4,239 3,857 $48.97
86618 580 535 $48.81
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 863 819 $43.26
84155 18 16 $34.35
87640 12 12 $33.51
80143 280 256 $33.00
80179 265 245 $33.00
87205 4,559 3,774 $28.51
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 14 13 $28.28
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 2,141 1,891 $28.20
J2060 Injection, lorazepam, 2 mg 5,069 3,951 $25.39
J1790 Injection, droperidol, up to 5 mg 1,737 1,496 $24.57
82010 1,300 1,106 $22.16
J1885 Injection, ketorolac tromethamine, per 15 mg 22,832 18,120 $22.14
76376 218 200 $16.97
J3360 Injection, diazepam, up to 5 mg 444 384 $16.30
J1630 Injection, haloperidol, up to 5 mg 1,873 1,488 $15.58
J0696 Injection, ceftriaxone sodium, per 250 mg 6,607 4,916 $14.48
84100 939 741 $13.56
J2405 Injection, ondansetron hydrochloride, per 1 mg 29,467 23,253 $13.55
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 2,576 1,949 $12.71
J1836 Injection, metronidazole, 10 mg 312 175 $12.03
J2765 Injection, metoclopramide hcl, up to 10 mg 6,290 5,315 $10.98
J0136 Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg 45 30 $10.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 8,371 6,904 $8.98
J1170 Injection, hydromorphone, up to 4 mg 11,535 7,986 $6.91
G0008 Administration of influenza virus vaccine 64 53 $6.00
87184 443 401 $5.88
82570 91 64 $4.94
J2270 Injection, morphine sulfate, up to 10 mg 5,516 4,610 $4.60
84156 87 64 $3.50
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 21,274 16,808 $3.05
J1100 Injection, dexamethasone sodium phosphate, 1 mg 9,543 7,718 $2.02
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 1,945 1,249 $2.00
J7120 Ringers lactate infusion, up to 1000 cc 25,775 20,363 $1.95
J1920 Injection, labetalol hydrochloride, 5 mg 121 105 $1.09
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 5,530 3,629 $1.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 467 368 $0.80
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 468 368 $0.79
84550 250 193 $0.46
G8996 Swallowing functional limitation, current status at therapy episode outset and at reporting intervals 73 56 $0.09
G8997 Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 73 56 $0.09
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 8,770 7,047 $0.08
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 4,582 3,043 $0.02
J0171 Injection, adrenalin, epinephrine, 0.1 mg 430 318 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 2,294 1,602 $0.00
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 82 37 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 307 274 $0.00
J0744 Injection, ciprofloxacin for intravenous infusion, 200 mg 284 185 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 2,072 1,742 $0.00
J1644 Injection, heparin sodium, per 1000 units 6,568 3,329 $0.00
J3370 Injection, vancomycin hcl, 500 mg 2,007 1,275 $0.00
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 74 72 $0.00
C1776 Joint device (implantable) 1,081 855 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 298 242 $0.00
99152 632 538 $0.00
12011 532 510 $0.00
91300 4,390 3,732 $0.00
J9190 Injection, fluorouracil, 500 mg 225 69 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 242 216 $0.00
J1650 Injection, enoxaparin sodium, 10 mg 414 238 $0.00
84439 50 44 $0.00
87207 93 49 $0.00
J7510 Prednisolone oral, per 5 mg 113 105 $0.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 16 13 $0.00
76937 76 70 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 68 66 $0.00
J0670 Injection, mepivacaine hydrochloride, per 10 ml 334 264 $0.00
82565 29 24 $0.00
C1758 Catheter, ureteral 43 38 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 150 139 $0.00
87075 30 26 $0.00
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 114 105 $0.00
J1171 Injection, hydromorphone, 0.1 mg 236 163 $0.00
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 81 69 $0.00
A9541 Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries 24 24 $0.00
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 117 107 $0.00
J0640 Injection, leucovorin calcium, per 50 mg 119 56 $0.00
90840 47 42 $0.00
80164 32 26 $0.00
64447 21 15 $0.00
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 100 88 $0.00
J3260 Injection, tobramycin sulfate, up to 80 mg 30 27 $0.00
Q0245 Injection, bamlanivimab and etesevimab, 2100 mg 47 30 $0.00
82140 14 13 $0.00
88112 45 38 $0.00
J2550 Injection, promethazine hcl, up to 50 mg 14 12 $0.00
J1953 Injection, levetiracetam, 10 mg 38 27 $0.00
J0688 Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg 12 12 $0.00
87469 13 12 $0.00
88312 13 13 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 12,259 9,982 $0.00
J8540 Dexamethasone, oral, 0.25 mg 3,515 1,464 $0.00
J0131 Injection, acetaminophen, not otherwise specified,10 mg 3,270 1,904 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 11,053 9,560 $0.00
J3480 Injection, potassium chloride, per 2 meq 480 221 $0.00
11045 2,063 859 $0.00
J2370 Injection, phenylephrine hcl, up to 1 ml 2,418 1,796 $0.00
C9290 Injection, bupivacaine liposome, 1 mg 1,303 956 $0.00
C1769 Guide wire 1,879 1,545 $0.00
A4301 Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.) 3,078 1,249 $0.00
J2704 Injection, propofol, 10 mg 32,684 18,975 $0.00
J1030 Injection, methylprednisolone acetate, 40 mg 751 622 $0.00
J1815 Injection, insulin, per 5 units 4,450 1,953 $0.00
12002 256 235 $0.00
A4217 Sterile water/saline, 500 ml 112 96 $0.00
J7050 Infusion, normal saline solution, 250 cc 6,535 3,251 $0.00
90839 214 180 $0.00
88341 527 489 $0.00
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 15 13 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 1,577 1,404 $0.00
A4648 Tissue marker, implantable, any type, each 551 498 $0.00
J0690 Injection, cefazolin sodium, 500 mg 10,180 6,277 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 956 736 $0.00
J7060 5% dextrose/water (500 ml = 1 unit) 943 243 $0.00
88307 127 116 $0.00
86308 81 76 $0.00
87015 236 190 $0.00
C2617 Stent, non-coronary, temporary, without delivery system 338 294 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 3,687 1,393 $0.00
77001 28 27 $0.00
A9585 Injection, gadobutrol, 0.1 ml 5,147 4,449 $0.00
A6213 Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing 116 78 $0.00
87808 153 136 $0.00
99153 Mod sedat endo service >5yrs 265 218 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 556 507 $0.00
C1781 Mesh (implantable) 235 217 $0.00
91301 404 367 $0.00
36416 77 53 $0.00
88300 514 450 $0.00
C1726 Catheter, balloon dilatation, non-vascular 213 204 $0.00
87486 100 88 $0.00
95885 68 63 $0.00
74420 30 27 $0.00
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 196 186 $0.00
96368 208 97 $0.00
87484 65 53 $0.00
82553 200 151 $0.00
J1940 Injection, furosemide, up to 20 mg 52 40 $0.00
J1010 Injection, methylprednisolone acetate, 1 mg 204 181 $0.00
J0360 Injection, hydralazine hcl, up to 20 mg 35 27 $0.00
64488 46 42 $0.00
87468 65 53 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 173 132 $0.00
87581 100 88 $0.00
91303 230 208 $0.00
87807 86 85 $0.00
83930 126 109 $0.00
91306 77 77 $0.00
88185 14 14 $0.00
86617 17 15 $0.00
91305 16 16 $0.00
11046 23 12 $0.00