Medicaid Provider Spending

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

PRISMA HEALTH-MIDLANDS

NPI: 1487868097 · COLUMBIA, SC 29203 · General Acute Care Hospital · NPI assigned 05/10/2007

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

Authorized official MILLER, POLLY controls 20+ related entities in our dataset. Read more

$68.26M
Total Medicaid Paid
1,764,832
Total Claims
1,387,460
Beneficiaries
562
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMILLER, POLLY (VP PAYOR STRATEGIES ALIGNMENT)
NPI Enumeration Date05/10/2007

Related Entities

Other providers sharing the same authorized official: MILLER, POLLY

ProviderCityStateTotal Paid
PRISMA HEALTH-MIDLANDS COLUMBIA SC $74.58M
PRISMA HEALTH-UPSTATE GREENVILLE SC $25.04M
PRISMA HEALTH-UPSTATE GREENVILLE SC $21.98M
PRISMA HEALTH-UPSTATE GREENVILLE SC $19.69M
PRISMA HEALTH-UPSTATE SENECA SC $15.64M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $11.77M
PRISMA HEALTH-UPSTATE GREENVILLE SC $10.74M
GREENVILLE HEALTH CORPORATION GREENVILLE SC $8.90M
PRISMA HEALTH-UPSTATE GREENVILLE SC $8.32M
PRISMA HEALTH-UPSTATE GREENVILLE SC $7.45M
PRISMA HEALTH UNIVERSITY MEDICAL GROUP GREENVILLE SC $7.44M
PRISMA HEALTH-MIDLANDS COULMBIA SC $7.43M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $6.88M
PRISMA HEALTH TUOMEY SUMTER SC $6.84M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $6.77M
PRISMA HEALTH-UPSTATE GREENVILLE SC $6.37M
PRISMA HEALTH-UPSTATE GREENVILLE SC $5.00M
PRISMA HEALTH-UPSTATE GREENVILLE SC $4.65M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $4.63M
PRISMA HEALTH-UPSTATE SENECA SC $4.48M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 234,313 $9.31M
2019 245,838 $9.12M
2020 195,312 $7.96M
2021 290,239 $10.20M
2022 317,955 $10.63M
2023 258,803 $10.05M
2024 222,372 $10.99M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
36415 Collection of venous blood by venipuncture 52,573 42,198 $5.70M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 84,385 26,182 $5.47M
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 2,692 2,536 $2.86M
80048 Basic metabolic panel (calcium, ionized) 42,331 32,629 $2.73M
99283 Emergency department visit for the evaluation and management, moderate severity 51,876 44,788 $2.55M
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 19,818 12,106 $2.40M
80053 Comprehensive metabolic panel 40,782 33,868 $2.15M
70551 Magnetic resonance imaging, brain; without contrast material 3,533 3,263 $1.93M
84156 1,761 1,506 $1.70M
99282 Emergency department visit for the evaluation and management, low to moderate severity 12,535 11,602 $1.60M
81025 15,698 14,357 $1.55M
G0463 Hospital outpatient clinic visit for assessment and management of a patient 32,589 26,566 $1.53M
96361 Intravenous infusion, hydration; each additional hour 18,835 11,900 $1.50M
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 9,274 8,295 $1.36M
80069 10,443 4,868 $1.36M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 29,027 25,243 $1.34M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 12,645 8,420 $1.26M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 16,110 13,044 $1.26M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 7,824 7,484 $1.16M
81003 13,764 10,573 $1.05M
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 7,254 6,494 $1.01M
95810 Polysomnography; sleep staging with 4 or more additional parameters 2,019 1,921 $953K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 11,226 10,609 $883K
86850 10,176 8,087 $757K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 12,616 4,199 $734K
95782 777 716 $715K
97530 Therapeutic activities, direct patient contact, each 15 minutes 18,047 5,975 $713K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 9,373 8,457 $710K
71046 Radiologic examination, chest; 2 views 20,691 18,879 $646K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 7,551 7,023 $595K
82570 4,576 4,203 $543K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 13,927 11,671 $518K
99284 Emergency department visit for the evaluation and management, high severity 29,132 26,025 $477K
74018 7,669 6,674 $460K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,958 1,866 $456K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 14,680 13,630 $407K
81001 27,960 24,902 $387K
70450 Computed tomography, head or brain; without contrast material 8,869 7,996 $368K
76770 2,599 2,506 $322K
97161 9,569 9,043 $298K
87086 Culture, bacterial; quantitative colony count, urine 15,203 13,789 $295K
99281 Emergency department visit for the evaluation and management, self-limited or minor 1,962 1,832 $292K
82565 1,652 1,554 $257K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 2,672 2,531 $250K
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 8,859 7,979 $249K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,317 1,955 $248K
93971 1,499 1,402 $241K
85347 1,828 1,505 $241K
36416 2,996 2,652 $241K
76700 Ultrasound, abdominal, real time with image documentation; complete 1,469 1,418 $232K
87081 4,490 4,297 $225K
86900 10,909 8,781 $218K
71250 1,086 1,036 $217K
87481 624 614 $215K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 21,338 18,501 $212K
76705 Ultrasound, abdominal, real time with image documentation; limited 3,859 3,621 $211K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 6,770 5,925 $200K
95951 1,322 516 $196K
87210 3,607 3,339 $196K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,885 4,220 $196K
92526 4,272 1,521 $191K
84702 4,880 4,047 $186K
92551 2,366 2,277 $184K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 74,008 56,871 $180K
72141 252 232 $173K
88305 Level IV - Surgical pathology, gross and microscopic examination 5,297 4,787 $170K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 487 460 $167K
93922 1,479 1,438 $164K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 2,852 2,644 $161K
74230 1,346 1,220 $161K
G0378 Hospital observation service, per hour 19,088 12,511 $152K
70250 436 410 $149K
93888 295 288 $145K
43762 1,421 1,246 $141K
87480 1,937 1,857 $139K
73130 2,175 1,940 $136K
87077 6,243 5,676 $135K
87070 3,201 2,820 $127K
71045 Radiologic examination, chest; single view 12,154 10,198 $124K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2,727 2,629 $118K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,417 1,322 $117K
76830 Ultrasound, transvaginal 1,101 1,044 $113K
76870 330 308 $108K
74177 Computed tomography, abdomen and pelvis; with contrast material 4,974 4,633 $105K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,251 2,170 $105K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 28,381 21,937 $104K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 7,745 4,937 $100K
95813 614 583 $99K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 135 127 $96K
73630 2,259 2,045 $95K
43760 273 224 $95K
73560 2,479 2,239 $94K
A4649 Surgical supply; miscellaneous 640 486 $93K
80061 Lipid panel 11,324 10,550 $93K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 269 218 $93K
71275 Computed tomographic angiography, chest, with contrast material 1,941 1,769 $93K
97535 Self-care/home management training, each 15 minutes 3,545 2,565 $92K
86780 7,170 6,691 $88K
73110 1,227 1,095 $83K
93970 543 522 $82K
73610 1,706 1,558 $81K
93880 632 615 $80K
76376 403 373 $78K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 8,757 8,079 $77K
J7042 5% dextrose/normal saline (500 ml = 1 unit) 1,996 1,230 $77K
85018 3,018 2,482 $75K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 1,106 868 $74K
73030 1,910 1,736 $74K
85027 16,216 12,610 $73K
73090 704 638 $73K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 1,379 1,335 $72K
74019 1,681 1,570 $70K
72040 1,226 1,171 $69K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 1,408 1,316 $66K
96375 Therapeutic injection; each additional sequential IV push 10,852 7,790 $65K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 2,449 2,093 $65K
0202U Oncology (prostate), multianalyte, gene expression profiling 439 414 $59K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 1,913 1,805 $58K
93017 2,364 2,253 $55K
97165 1,960 1,773 $55K
83655 1,177 1,091 $52K
76536 471 462 $51K
77063 Screening digital breast tomosynthesis, bilateral 454 447 $50K
70496 581 524 $50K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 1,839 732 $49K
84703 952 843 $48K
72100 1,629 1,559 $47K
83036 Hemoglobin; glycosylated (A1C) 12,488 11,625 $47K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 2,018 1,957 $45K
77067 Screening mammography, bilateral, including computer-aided detection 1,485 1,438 $44K
86902 2,135 1,602 $43K
75809 103 93 $41K
95700 481 432 $41K
72125 Computed tomography, cervical spine; without contrast material 2,278 2,126 $40K
97162 1,423 1,249 $40K
76937 2,729 2,309 $38K
73502 1,156 1,077 $38K
86140 6,450 5,480 $37K
88304 2,752 2,529 $36K
73590 998 889 $36K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 1,317 1,264 $35K
74176 Computed tomography, abdomen and pelvis; without contrast material 514 478 $34K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 436 404 $34K
12011 291 270 $32K
92523 859 790 $32K
80074 1,727 1,590 $32K
82043 2,924 2,807 $32K
95716 214 166 $30K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 5,065 3,076 $28K
36591 1,628 1,135 $28K
90460 Immunization administration through 18 years of age via any route, first or only component 8,588 8,156 $28K
93925 511 503 $28K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 161 160 $28K
77072 675 660 $27K
94760 2,971 1,388 $27K
76000 1,166 1,083 $26K
P9016 Red blood cells, leukocytes reduced, each unit 3,274 2,515 $25K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 240 222 $25K
82272 740 676 $24K
76642 438 399 $24K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 513 478 $24K
84439 3,885 3,626 $23K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 4,913 2,192 $23K
93458 709 598 $22K
80081 464 432 $22K
84443 Thyroid stimulating hormone (TSH) 12,262 11,209 $22K
84145 3,156 2,522 $21K
85610 11,148 8,473 $19K
80076 3,415 2,995 $18K
54360 169 162 $18K
93926 371 351 $18K
87428 206 200 $18K
73070 140 131 $18K
82728 4,580 4,021 $18K
97597 603 426 $18K
C1769 Guide wire 2,838 2,480 $17K
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 1,576 1,391 $17K
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 279 265 $17K
12001 144 138 $16K
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision 718 680 $16K
85660 1,214 904 $16K
82950 2,078 1,999 $15K
76801 1,274 1,091 $15K
92610 812 700 $15K
76885 104 100 $15K
10060 128 121 $15K
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 2,001 1,115 $15K
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants 30 27 $15K
82550 2,897 2,119 $14K
85014 953 764 $14K
89051 452 379 $14K
84484 13,256 9,166 $14K
95811 50 49 $14K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 11,884 9,958 $14K
73080 27 24 $14K
80177 1,053 903 $13K
90686 6,386 6,119 $13K
74022 458 418 $13K
99174 194 192 $13K
83735 22,513 16,270 $12K
59025 Fetal non-stress test 279 187 $12K
70360 161 146 $12K
84132 1,442 1,207 $11K
88142 1,638 1,558 $11K
70486 248 240 $11K
74183 12 12 $10K
97113 407 161 $10K
87807 232 209 $10K
86901 10,933 8,802 $10K
36600 221 184 $9K
87641 460 379 $9K
99215 Prolong outpt/office vis 459 366 $9K
17250 31 26 $9K
83037 683 628 $8K
J3490 Unclassified drugs 14,577 9,736 $8K
97116 2,723 1,159 $8K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 133 131 $8K
83020 4,585 3,883 $8K
82607 2,062 1,898 $8K
J7120 Ringers lactate infusion, up to 1000 cc 30,967 26,337 $7K
J1650 Injection, enoxaparin sodium, 10 mg 4,381 925 $7K
87631 965 877 $7K
75574 119 117 $7K
87040 3,421 2,606 $7K
82247 127 91 $7K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 1,122 961 $7K
0002A 272 270 $7K
96523 151 112 $7K
83001 281 269 $7K
J7050 Infusion, normal saline solution, 250 cc 3,569 2,542 $6K
82657 346 329 $6K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 194 185 $6K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 9,445 8,802 $6K
A9585 Injection, gadobutrol, 0.1 ml 2,632 2,452 $6K
95957 992 427 $6K
J2704 Injection, propofol, 10 mg 2,185 1,688 $6K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 2,056 1,952 $6K
J3010 Injection, fentanyl citrate, 0.1 mg 21,831 18,271 $5K
97166 125 106 $5K
74455 24 24 $5K
73552 244 219 $5K
99381 76 73 $5K
69209 12 12 $5K
86803 4,641 4,277 $5K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 14,893 13,745 $5K
82330 919 765 $5K
90656 543 537 $5K
93325 176 167 $5K
72156 13 13 $5K
86580 354 272 $5K
70498 618 551 $5K
J1815 Injection, insulin, per 5 units 2,496 1,013 $5K
C1751 Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) 82 69 $5K
82105 386 366 $5K
76886 26 25 $5K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 190 91 $4K
J7030 Infusion, normal saline solution , 1000 cc 10,147 7,845 $4K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 15,946 13,770 $4K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 53 50 $4K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 69 66 $4K
86361 509 468 $4K
J2270 Injection, morphine sulfate, up to 10 mg 5,646 4,087 $4K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 37 33 $4K
70491 39 39 $4K
J0690 Injection, cefazolin sodium, 500 mg 7,702 5,842 $4K
93226 14 13 $4K
96367 673 532 $4K
82945 20 12 $4K
86592 585 454 $4K
83516 408 392 $4K
72170 167 149 $4K
J2405 Injection, ondansetron hydrochloride, per 1 mg 23,430 18,979 $4K
85379 831 754 $4K
83540 3,113 2,856 $4K
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 347 255 $4K
86920 3,213 2,329 $4K
76818 182 95 $3K
82805 1,350 1,123 $3K
99173 570 529 $3K
J0780 Injection, prochlorperazine, up to 10 mg 515 470 $3K
84146 256 247 $3K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 60 55 $3K
76775 31 31 $3K
93297 86 86 $3K
93923 12 12 $3K
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 365 342 $3K
J1885 Injection, ketorolac tromethamine, per 15 mg 10,556 8,529 $3K
0072A 103 102 $3K
J0330 Injection, succinylcholine chloride, up to 20 mg 3,610 3,144 $3K
80143 153 141 $3K
90715 3,628 3,421 $3K
82784 870 767 $3K
J0696 Injection, ceftriaxone sodium, per 250 mg 5,178 3,857 $3K
85730 6,263 5,137 $3K
86706 895 724 $3K
77066 Tomosynthesis, mammo 33 27 $3K
87015 29 24 $2K
J2060 Injection, lorazepam, 2 mg 2,532 1,751 $2K
11982 13 12 $2K
J1170 Injection, hydromorphone, up to 4 mg 6,826 3,580 $2K
82040 132 106 $2K
83690 8,613 7,558 $2K
94664 3,424 1,687 $2K
86704 385 275 $2K
86480 421 351 $2K
T1015 Clinic visit/encounter, all-inclusive 45 42 $2K
83880 4,567 3,826 $2K
0001A 336 313 $2K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 531 476 $2K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 6,071 4,559 $2K
90620 497 480 $2K
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 165 158 $2K
72146 12 12 $2K
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 1,962 1,719 $2K
J3480 Injection, potassium chloride, per 2 meq 1,298 823 $2K
J1200 Injection, diphenhydramine hcl, up to 50 mg 3,057 2,112 $2K
93299 31 28 $2K
90647 1,813 1,717 $2K
G0476 Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test 39 31 $2K
96376 7,856 4,281 $2K
88300 91 85 $2K
J1050 Injection, medroxyprogesterone acetate, 1 mg 3,906 3,813 $2K
80164 240 193 $2K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 319 309 $1K
0071A 154 151 $1K
92609 128 41 $1K
95816 14 12 $1K
41899 Unlisted procedure, dentoalveolar structures 819 699 $1K
87340 5,172 4,600 $1K
83615 1,864 1,280 $1K
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 552 309 $1K
87205 2,979 2,624 $1K
36430 3,819 2,751 $1K
74240 12 12 $1K
29515 58 28 $1K
82140 47 39 $1K
86762 2,514 2,204 $1K
80197 457 267 $1K
76882 15 13 $1K
J2250 Injection, midazolam hydrochloride, per 1 mg 10,675 9,347 $1K
90633 1,790 1,696 $1K
Q5106 Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units 660 90 $1K
83993 26 26 $953.57
82785 91 89 $896.77
94010 12 12 $893.62
76819 Fetal biophysical profile; without non-stress testing 140 68 $876.33
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 4,740 4,422 $850.69
90670 2,164 2,001 $835.73
84100 5,496 3,517 $828.49
90651 1,113 1,084 $817.29
73060 54 50 $770.16
0004A 206 198 $763.60
72070 30 29 $735.26
76641 12 12 $719.45
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 7,811 5,717 $695.42
87536 565 538 $695.22
74220 12 12 $676.95
88307 122 107 $662.65
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 84 77 $649.18
87486 49 38 $617.86
82670 38 37 $614.46
82310 120 106 $571.75
83605 3,183 2,586 $543.03
88342 685 591 $540.64
87522 Neg quan hep c or qual rna 121 112 $538.32
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 1,144 759 $532.40
82248 338 257 $529.91
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 1,197 1,174 $517.62
99152 1,374 1,284 $514.11
90677 958 931 $504.86
76857 81 76 $504.38
A9270 Non-covered item or service 9,450 4,456 $502.16
99188 265 247 $501.55
85652 3,630 3,224 $490.01
86038 398 382 $473.43
90662 521 508 $467.24
82746 1,082 1,001 $428.18
0124A 510 498 $393.20
H0002 Behavioral health screening to determine eligibility for admission to treatment program 15 15 $375.72
99205 Prolong outpt/office vis 13 13 $363.13
0054A 232 228 $355.86
90685 400 371 $324.58
86870 15 12 $317.48
91320 442 425 $286.82
87102 41 26 $284.68
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 268 229 $282.96
86923 1,090 842 $257.99
85045 9,633 7,572 $249.26
80162 14 12 $242.40
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 17 14 $240.46
82627 28 26 $221.53
86682 120 64 $220.74
82962 17 12 $213.25
86003 96 90 $206.49
82947 233 205 $198.18
84403 184 175 $196.56
90649 489 469 $195.18
Q9957 Injection, perflutren lipid microspheres, per ml 515 490 $184.69
C1760 Closure device, vascular (implantable/insertable) 50 48 $160.14
90746 31 30 $153.58
0081A 41 41 $122.22
90480 510 478 $122.22
36592 29 12 $121.93
90472 Immunization administration, each additional vaccine (list separately) 263 241 $121.93
84550 180 164 $118.37
90723 1,777 1,677 $112.62
90734 1,394 1,328 $107.91
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 57 56 $107.79
84481 330 322 $94.17
90682 154 136 $93.42
82077 901 827 $90.00
90700 116 111 $88.21
92611 1,197 1,083 $85.94
0154A 28 28 $77.78
90696 162 159 $65.74
0051A 14 13 $40.74
90707 122 115 $38.00
86708 178 105 $35.85
87116 38 24 $34.92
84425 596 583 $30.11
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 2,254 1,982 $30.11
86787 456 370 $26.42
85576 44 38 $22.64
87075 290 276 $19.47
84134 543 517 $18.80
90710 140 137 $18.00
84295 166 130 $15.26
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 41 26 $12.88
86200 56 52 $12.58
J2795 Injection, ropivacaine hydrochloride, 1 mg 2,599 2,393 $7.27
J0171 Injection, adrenalin, epinephrine, 0.1 mg 344 270 $0.76
J0280 Injection, aminophyllin, up to 250 mg 731 711 $0.00
J2785 Injection, regadenoson, 0.1 mg 1,696 1,616 $0.00
J2370 Injection, phenylephrine hcl, up to 1 ml 1,120 832 $0.00
90716 117 112 $0.00
87510 1,937 1,857 $0.00
J1940 Injection, furosemide, up to 20 mg 1,199 783 $0.00
94644 744 650 $0.00
86800 25 25 $0.00
42820 Tonsillectomy and adenoidectomy; younger than age 12 1,064 1,026 $0.00
42830 39 38 $0.00
36410 1,112 924 $0.00
G0257 Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility 1,461 498 $0.00
G0008 Administration of influenza virus vaccine 1,651 1,595 $0.00
99153 Mod sedat endo service >5yrs 735 679 $0.00
J1630 Injection, haloperidol, up to 5 mg 294 165 $0.00
86921 674 498 $0.00
J0360 Injection, hydralazine hcl, up to 20 mg 220 169 $0.00
S0020 Injection, bupivicaine hydrochloride, 30 ml 1,481 1,219 $0.00
J0697 Injection, sterile cefuroxime sodium, per 750 mg 30 24 $0.00
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 296 271 $0.00
G0009 Administration of pneumococcal vaccine 219 215 $0.00
88341 67 63 $0.00
82553 903 501 $0.00
86317 101 90 $0.00
G0379 Direct admission of patient for hospital observation care 790 756 $0.00
G8998 Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting 15 12 $0.00
90378 314 238 $0.00
31231 15 12 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 575 521 $0.00
86160 242 219 $0.00
83002 195 185 $0.00
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 207 163 $0.00
86376 78 74 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 204 195 $0.00
J2780 Injection, ranitidine hydrochloride, 25 mg 16 12 $0.00
86225 31 28 $0.00
87581 49 38 $0.00
D7140 Extraction, erupted tooth or exposed root 90 84 $0.00
12002 14 14 $0.00
J2765 Injection, metoclopramide hcl, up to 10 mg 27 25 $0.00
V2632 Posterior chamber intraocular lens 16 14 $0.00
45380 Colonoscopy, flexible; with biopsy, single or multiple 13 12 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 14 12 $0.00
90732 56 53 $0.00
86255 193 184 $0.00
D1206 Topical application of fluoride varnish 38 38 $0.00
G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 15 12 $0.00
86364 13 13 $0.00
84436 57 54 $0.00
85651 162 153 $0.00
31622 16 12 $0.00
83520 12 12 $0.00
J7060 5% dextrose/water (500 ml = 1 unit) 19 14 $0.00
90935 Hemodialysis procedure with single evaluation by a physician 24 12 $0.00
G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals 15 12 $0.00
77001 14 12 $0.00
84402 16 14 $0.00
87206 23 12 $0.00
51600 24 24 $0.00
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 17 12 $0.00
J1644 Injection, heparin sodium, per 1000 units 6,343 3,004 $0.00
86922 1,276 921 $0.00
87799 757 696 $0.00
J3370 Injection, vancomycin hcl, 500 mg 703 461 $0.00
C1887 Catheter, guiding (may include infusion/perfusion capability) 983 880 $0.00
90461 1,665 1,555 $0.00
87660 1,917 1,837 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 341 316 $0.00
90681 842 799 $0.00
87186 4,916 4,458 $0.00
86235 59 55 $0.00
93976 1,973 1,794 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 1,693 1,271 $0.00
84466 2,700 2,473 $0.00
S0077 Injection, clindamycin phosphate, 300 mg 200 154 $0.00
J1756 Injection, iron sucrose, 1 mg 130 65 $0.00
80323 54 53 $0.00
82610 45 44 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 698 535 $0.00
83970 412 380 $0.00
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 48 47 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 433 418 $0.00
D1120 Prophylaxis - child 39 37 $0.00
87512 625 615 $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 357 264 $0.00
J2550 Injection, promethazine hcl, up to 50 mg 975 680 $0.00
S5010 5% dextrose and 0.45% normal saline, 1000 ml 1,409 771 $0.00
84460 138 131 $0.00
J1598 Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg 234 220 $0.00
85384 238 195 $0.00
82010 50 45 $0.00
J1953 Injection, levetiracetam, 10 mg 261 191 $0.00
82977 283 222 $0.00
84450 139 132 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 685 543 $0.00
86431 112 106 $0.00
88312 16 13 $0.00
C9113 Injection, pantoprazole sodium, per vial 194 89 $0.00
G0390 Trauma response team associated with hospital critical care service 50 47 $0.00
J7510 Prednisolone oral, per 5 mg 155 129 $0.00
G8997 Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 51 38 $0.00
80179 131 124 $0.00
86735 134 68 $0.00
93750 258 196 $0.00
G8996 Swallowing functional limitation, current status at therapy episode outset and at reporting intervals 50 37 $0.00
86774 129 64 $0.00
J2274 Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg 498 354 $0.00
J9370 Vincristine sulfate, 1 mg 22 12 $0.00
86765 133 67 $0.00
54161 41 41 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 147 109 $0.00
D2934 13 13 $0.00
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 14 14 $0.00
94645 16 15 $0.00
J0736 Injection, clindamycin phosphate, 300 mg 24 14 $0.00
93356 12 12 $0.00
84305 58 57 $0.00
86696 14 13 $0.00
J0885 Injection, epoetin alfa, (for non-esrd use), 1000 units 76 14 $0.00
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 79 62 $0.00
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 15 13 $0.00
54163 13 12 $0.00
84590 13 12 $0.00
95714 64 50 $0.00
D2930 Prefabricated stainless steel crown - primary tooth 16 14 $0.00
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 48 37 $0.00
J0692 Injection, cefepime hydrochloride, 500 mg 23 12 $0.00
88104 29 26 $0.00
86705 16 13 $0.00
84630 18 17 $0.00
J1171 Injection, hydromorphone, 0.1 mg 89 69 $0.00