Medicaid Provider Spending

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

LAKE CUMBERLAND REGIONAL HOSPITAL LLC

NPI: 1619038247 · SOMERSET, KY 42502 · Rural Acute Care Hospital · NPI assigned 12/13/2006

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

Authorized official LAWRENCE, CHARLOTTE controls 20+ related entities in our dataset. Read more

$77.77M
Total Medicaid Paid
1,511,966
Total Claims
1,125,083
Beneficiaries
388
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLAWRENCE, CHARLOTTE (SECRETARY)
NPI Enumeration Date12/13/2006

Related Entities

Other providers sharing the same authorized official: LAWRENCE, CHARLOTTE

ProviderCityStateTotal Paid
DANVILLE REGIONAL MEDICAL CENTER, LLC DANVILLE VA $65.11M
PHC-LAS CRUCES INC LAS CRUCES NM $64.77M
GEORGETOWN COMMUNITY HOSPITAL LLC GEORGETOWN KY $44.03M
PINELAKE REGIONAL HOSPITAL LLC MAYFIELD KY $43.34M
RALEIGH GENERAL HOSPITAL LLC BECKLEY WV $36.44M
LOURDES HOSPITAL LLC PASCO WA $33.94M
RCHP-SIERRA VISTA INC SIERRA VISTA AZ $29.77M
CLINCH VALLEY MEDICAL CENTER INC. RICHLANDS VA $26.28M
SPRING VIEW HOSPITAL LLC LEBANON KY $23.35M
HAVASU REGIONAL MEDICAL CENTER LLC LAKE HAVASU CITY AZ $23.19M
LAS CRUCES PHYSICIAN PRACTICES, LLC LAS CRUCES NM $22.78M
MEADOWVIEW REGIONAL MEDICAL CENTER LLC MAYSVILLE KY $22.57M
LOURDES HOSPITAL LLC RICHLAND WA $22.38M
DANVILLE REGIONAL MEDICAL CENTER LLC MARTINSVILLE VA $21.09M
PHC-FORT MOHAVE INC FORT MOHAVE AZ $19.95M
WYTHE COUNTY COMMUNITY HOSPITAL LLC WYTHEVILLE VA $18.30M
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC JOHNSTOWN PA $18.22M
BOURBON COMMUNITY HOSPITAL LLC PARIS KY $18.14M
WILLAMETTE VALLEY MEDICAL CENTER LLC MCMINNVILLE OR $17.29M
LAKE CUMBERLAND REGIONAL HOSPITAL, LLC SOMERSET KY $15.55M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 197,476 $11.89M
2019 193,592 $10.91M
2020 187,448 $10.61M
2021 233,930 $11.10M
2022 238,819 $10.13M
2023 260,161 $12.38M
2024 200,540 $10.75M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 50,010 39,295 $13.40M
99284 Emergency department visit for the evaluation and management, high severity 44,047 38,056 $7.00M
74176 Computed tomography, abdomen and pelvis; without contrast material 15,381 11,877 $5.20M
99283 Emergency department visit for the evaluation and management, moderate severity 24,569 22,334 $2.88M
93458 3,194 1,887 $2.88M
74177 Computed tomography, abdomen and pelvis; with contrast material 6,436 5,005 $2.51M
G0378 Hospital observation service, per hour 8,655 6,406 $2.17M
70450 Computed tomography, head or brain; without contrast material 10,824 8,057 $1.85M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 38,249 27,288 $1.57M
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 20,270 17,669 $1.47M
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 35,722 30,055 $1.41M
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 1,797 1,450 $1.33M
96375 Therapeutic injection; each additional sequential IV push 23,230 17,127 $1.15M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3,701 3,206 $997K
88305 Level IV - Surgical pathology, gross and microscopic examination 10,889 9,655 $992K
71046 Radiologic examination, chest; 2 views 21,267 17,108 $826K
80053 Comprehensive metabolic panel 107,936 69,973 $782K
72125 Computed tomography, cervical spine; without contrast material 3,533 3,055 $734K
71045 Radiologic examination, chest; single view 25,897 16,444 $733K
36415 Collection of venous blood by venipuncture 149,010 74,932 $708K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 2,193 2,036 $689K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 28,171 19,849 $688K
62323 2,913 2,210 $668K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 13,220 11,478 $638K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 14,992 6,302 $638K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 1,637 1,500 $593K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 87,688 68,323 $565K
99282 Emergency department visit for the evaluation and management, low to moderate severity 7,115 6,636 $522K
96361 Intravenous infusion, hydration; each additional hour 30,126 14,973 $508K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 10,938 2,588 $493K
76705 Ultrasound, abdominal, real time with image documentation; limited 5,168 4,751 $470K
71275 Computed tomographic angiography, chest, with contrast material 2,515 1,900 $469K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 3,183 2,616 $443K
J7030 Infusion, normal saline solution , 1000 cc 23,294 19,476 $435K
71250 3,641 3,282 $422K
71260 Computed tomography, thorax, diagnostic; with contrast material 2,699 2,005 $401K
99218 1,478 1,241 $390K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 1,297 1,013 $383K
70551 Magnetic resonance imaging, brain; without contrast material 1,338 1,127 $382K
95810 Polysomnography; sleep staging with 4 or more additional parameters 805 741 $368K
70498 1,487 1,084 $360K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 7,010 2,818 $350K
74178 840 564 $334K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 4,477 3,604 $331K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1,331 976 $326K
41899 Unlisted procedure, dentoalveolar structures 450 430 $316K
72131 1,807 1,396 $310K
47563 432 325 $303K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 7,975 4,987 $295K
70486 1,490 1,366 $280K
73564 4,703 3,642 $271K
84484 20,467 16,922 $269K
72141 759 667 $259K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 9,877 8,999 $243K
73630 4,082 3,575 $239K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 8,967 3,966 $238K
45380 Colonoscopy, flexible; with biopsy, single or multiple 1,122 959 $236K
93017 1,229 1,115 $223K
72110 2,389 1,983 $220K
70496 1,035 820 $217K
73221 626 573 $216K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 1,320 795 $213K
93971 1,794 1,638 $210K
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 3,438 3,037 $208K
74018 4,205 3,406 $202K
73130 3,868 3,122 $202K
73610 3,765 3,185 $198K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 740 673 $197K
99281 Emergency department visit for the evaluation and management, self-limited or minor 5,372 4,807 $194K
J7120 Ringers lactate infusion, up to 1000 cc 7,311 5,336 $185K
73030 4,241 3,252 $181K
76700 Ultrasound, abdominal, real time with image documentation; complete 1,165 1,077 $172K
95811 437 390 $170K
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml 1,845 1,709 $161K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 11,989 11,324 $160K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1,202 1,138 $154K
87428 5,718 4,935 $146K
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 1,940 1,601 $146K
J7050 Infusion, normal saline solution, 250 cc 9,701 6,224 $145K
J2270 Injection, morphine sulfate, up to 10 mg 9,585 7,227 $144K
73110 2,955 2,379 $143K
77067 Screening mammography, bilateral, including computer-aided detection 2,757 2,622 $141K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 629 464 $139K
C1769 Guide wire 3,045 2,701 $137K
72128 748 633 $136K
88304 3,743 3,287 $132K
84443 Thyroid stimulating hormone (TSH) 9,544 8,703 $125K
80048 Basic metabolic panel (calcium, ionized) 17,784 11,540 $123K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 4,682 2,033 $121K
81025 18,368 16,064 $121K
78226 726 584 $118K
76641 1,454 1,357 $115K
83605 12,303 10,821 $115K
83690 19,584 17,281 $113K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,942 2,610 $112K
76770 1,336 1,232 $111K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 15,294 10,332 $110K
76536 1,378 1,291 $109K
62321 429 342 $108K
76000 1,943 1,582 $107K
96376 8,171 4,273 $100K
C1760 Closure device, vascular (implantable/insertable) 1,061 949 $97K
72100 1,961 1,619 $97K
78815 Positron emission tomography (PET) for limited area imaging 210 165 $96K
73080 1,563 1,306 $93K
0240U 1,159 1,030 $91K
G0379 Direct admission of patient for hospital observation care 1,203 1,064 $91K
83735 14,885 12,424 $86K
12001 1,729 1,514 $82K
42820 Tonsillectomy and adenoidectomy; younger than age 12 158 154 $82K
82962 23,232 16,650 $82K
81001 31,208 27,337 $80K
77336 845 250 $75K
97161 3,899 1,584 $74K
87081 12,686 11,654 $73K
73502 1,607 1,153 $71K
83880 2,441 2,153 $68K
87086 Culture, bacterial; quantitative colony count, urine 9,389 8,278 $66K
82803 3,525 3,052 $66K
73590 1,489 1,227 $66K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 1,518 534 $65K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 669 632 $65K
J2360 Injection, orphenadrine citrate, up to 60 mg 2,280 2,137 $65K
93975 450 424 $64K
80061 Lipid panel 7,052 5,323 $61K
71101 908 720 $60K
J0696 Injection, ceftriaxone sodium, per 250 mg 857 735 $58K
72170 1,578 1,066 $56K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 3,307 2,869 $55K
88307 722 551 $54K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 130 117 $54K
88312 1,537 1,463 $53K
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 2,807 2,563 $52K
77334 126 78 $52K
84702 3,932 2,977 $51K
80074 1,619 1,338 $51K
87040 4,020 3,440 $51K
73090 1,289 1,111 $49K
77080 1,279 968 $49K
85610 13,931 11,508 $48K
88313 1,254 1,161 $48K
64493 276 182 $48K
71271 1,846 1,681 $48K
J1040 Injection, methylprednisolone acetate, 80 mg 2,960 2,742 $46K
93880 358 300 $43K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 2,223 1,897 $43K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,238 1,015 $43K
C1889 Implantable/insertable device, not otherwise classified 563 426 $42K
85379 4,860 4,448 $41K
84703 6,293 5,788 $40K
87077 6,696 4,852 $40K
97530 Therapeutic activities, direct patient contact, each 15 minutes 3,875 1,429 $40K
85730 8,593 7,281 $38K
77063 Screening digital breast tomosynthesis, bilateral 3,789 3,067 $38K
87186 4,450 4,042 $36K
76870 379 350 $36K
72050 452 374 $35K
J1815 Injection, insulin, per 5 units 2,207 1,610 $35K
10060 464 366 $34K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,830 2,479 $34K
87522 Neg quan hep c or qual rna 817 767 $33K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 1,080 993 $32K
77412 319 25 $32K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 1,079 992 $32K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 1,773 1,184 $29K
87807 2,537 2,432 $29K
J1200 Injection, diphenhydramine hcl, up to 50 mg 3,022 2,739 $28K
C9600 Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch 113 12 $28K
83036 Hemoglobin; glycosylated (A1C) 4,264 3,786 $28K
86850 4,209 3,247 $28K
81015 7,748 6,738 $27K
J2550 Injection, promethazine hcl, up to 50 mg 2,681 2,166 $26K
73560 1,174 902 $26K
36600 2,343 1,821 $25K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 1,004 448 $25K
86140 5,558 4,738 $25K
J2250 Injection, midazolam hydrochloride, per 1 mg 1,647 1,396 $24K
74246 206 202 $24K
84146 1,347 1,237 $24K
43249 129 77 $24K
73140 582 508 $23K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 114 110 $22K
87070 4,165 2,117 $22K
90715 1,772 1,659 $22K
82565 1,977 1,508 $22K
70491 113 75 $22K
12002 386 332 $21K
J0153 Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) 143 121 $21K
82607 1,822 1,530 $20K
77300 146 51 $19K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 1,136 918 $19K
12011 472 427 $19K
J7799 Noc drugs, other than inhalation drugs, administered through dme 782 580 $19K
80143 1,231 1,077 $19K
76001 148 134 $19K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 1,137 951 $19K
C1874 Stent, coated/covered, with delivery system 18 15 $18K
J1885 Injection, ketorolac tromethamine, per 15 mg 5,233 4,634 $18K
72052 270 207 $17K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 2,872 2,266 $17K
84439 2,385 2,172 $16K
76801 421 379 $16K
80179 1,071 993 $16K
77066 Tomosynthesis, mammo 260 246 $16K
80324 559 488 $16K
86901 5,814 4,684 $15K
17250 363 190 $15K
85027 2,998 2,509 $15K
73562 264 199 $15K
86900 6,086 4,708 $15K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 369 361 $14K
84153 1,415 1,181 $14K
J2060 Injection, lorazepam, 2 mg 1,428 1,223 $14K
J0690 Injection, cefazolin sodium, 500 mg 2,017 1,506 $14K
G0297 Low dose ct scan (ldct) for lung cancer screening 524 472 $13K
88112 277 222 $13K
84520 1,305 1,148 $13K
72070 256 202 $13K
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 123 121 $13K
G0475 Hiv antigen/antibody, combination assay, screening 499 436 $13K
52356 13 12 $13K
G0399 Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation 212 195 $12K
88342 330 301 $12K
82010 1,421 1,233 $11K
J2785 Injection, regadenoson, 0.1 mg 113 98 $11K
74300 107 104 $11K
82728 1,006 866 $10K
74420 108 100 $10K
82550 1,565 1,271 $10K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 239 214 $10K
74021 188 172 $10K
0012A 592 488 $9K
97164 350 333 $9K
97165 383 298 $9K
72072 152 124 $9K
85652 3,609 3,103 $9K
93970 72 65 $9K
74019 206 187 $9K
84100 1,556 1,287 $8K
73600 235 182 $8K
97116 887 378 $8K
82150 1,441 1,301 $8K
96367 732 472 $8K
C1758 Catheter, ureteral 342 308 $8K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 22 22 $8K
0011A 666 531 $8K
84403 357 316 $8K
87205 1,761 1,562 $7K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 82 69 $7K
J7060 5% dextrose/water (500 ml = 1 unit) 323 210 $7K
78264 37 25 $7K
C1887 Catheter, guiding (may include infusion/perfusion capability) 326 290 $6K
J0583 Injection, bivalirudin, 1 mg 12 12 $6K
J1170 Injection, hydromorphone, up to 4 mg 5,188 3,614 $6K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 66 61 $6K
80076 466 340 $6K
86255 398 378 $6K
82784 509 455 $6K
C1726 Catheter, balloon dilatation, non-vascular 24 24 $6K
93925 51 42 $6K
J1580 Injection, garamycin, gentamicin, up to 80 mg 349 290 $6K
J2405 Injection, ondansetron hydrochloride, per 1 mg 6,829 5,711 $6K
72020 115 102 $5K
64635 12 12 $5K
94375 59 49 $5K
84145 261 237 $5K
J1030 Injection, methylprednisolone acetate, 40 mg 253 248 $5K
82248 868 652 $5K
A9510 Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries 197 187 $5K
20553 15 14 $5K
83550 658 617 $5K
86038 478 444 $5K
83540 925 849 $5K
76830 Ultrasound, transvaginal 48 44 $4K
97535 Self-care/home management training, each 15 minutes 555 279 $4K
G0103 Prostate cancer screening; prostate specific antigen test (psa) 649 315 $4K
88302 126 109 $4K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 1,087 1,022 $4K
C2617 Stent, non-coronary, temporary, without delivery system 54 51 $4K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 25 24 $4K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 83 78 $4K
73552 71 65 $4K
J0780 Injection, prochlorperazine, up to 10 mg 656 563 $3K
G0433 Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening 225 209 $3K
J1644 Injection, heparin sodium, per 1000 units 425 249 $3K
83516 142 133 $3K
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 91 85 $3K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 24 24 $3K
77280 44 12 $3K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 70 50 $3K
36430 27 24 $3K
J2919 Injection, methylprednisolone sodium succinate, 5 mg 367 316 $3K
80305 251 244 $2K
92526 50 38 $2K
93660 17 17 $2K
93922 13 12 $2K
83970 44 42 $2K
86308 465 435 $2K
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography 34 26 $2K
J1010 Injection, methylprednisolone acetate, 1 mg 123 120 $2K
82746 155 149 $2K
J2800 Injection, methocarbamol, up to 10 ml 344 316 $2K
73060 58 42 $2K
86706 201 194 $2K
C1781 Mesh (implantable) 16 12 $2K
82042 364 321 $2K
82308 81 74 $2K
95816 19 12 $2K
74230 52 24 $2K
83520 89 86 $2K
82103 131 112 $2K
J3475 Injection, magnesium sulfate, per 500 mg 259 227 $2K
88300 88 86 $1K
87210 314 288 $1K
82570 348 319 $1K
76642 15 14 $1K
83010 76 70 $1K
94729 27 24 $1K
29126 30 29 $1K
94727 27 24 $1K
C1765 Adhesion barrier 22 13 $1K
84550 265 236 $1K
97162 13 13 $1K
73100 37 24 $1K
85007 357 307 $1K
81596 25 25 $1K
P9016 Red blood cells, leukocytes reduced, each unit 27 12 $1K
87899 43 39 $1K
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 63 40 $1K
87340 93 91 $924.79
83615 213 183 $918.37
86708 83 81 $906.36
99499 73 59 $900.75
83883 73 68 $898.50
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 40 24 $882.65
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 1,835 1,747 $861.37
J0694 Injection, cefoxitin sodium, 1 gm 35 28 $715.02
87075 38 36 $710.41
82104 61 59 $694.78
77065 Tomosynthesis, mammo 13 13 $688.12
70360 15 13 $648.05
A9270 Non-covered item or service 2,143 567 $622.76
82272 173 161 $591.37
82140 54 52 $581.28
82247 132 93 $517.08
36416 105 67 $481.37
86703 73 68 $445.26
96368 37 31 $437.06
87339 32 29 $433.01
90714 41 38 $427.56
83874 47 39 $393.42
80069 64 38 $375.17
94200 27 24 $345.57
85576 17 15 $332.29
84436 57 48 $322.37
86780 30 27 $290.92
86677 13 13 $288.04
87045 29 27 $287.26
86803 26 24 $270.05
11045 38 12 $249.93
86696 12 12 $248.86
84402 15 12 $240.75
82390 25 24 $218.80
86381 15 14 $193.94
C1766 Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away 18 17 $187.43
J0360 Injection, hydralazine hcl, up to 20 mg 42 38 $179.20
80320 34 32 $176.83
86704 12 12 $169.44
80164 15 13 $150.52
86695 12 12 $144.81
82310 43 25 $131.02
87015 13 12 $122.31
88311 12 12 $121.28
J1171 Injection, hydromorphone, 0.1 mg 75 60 $114.69
86015 13 12 $111.37
Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) 19 14 $110.24
G0008 Administration of influenza virus vaccine 18 14 $103.00
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 567 541 $92.19
Q0177 Hydroxyzine pamoate, 25 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 13 13 $83.43
87400 124 43 $48.25
86592 13 13 $45.94
91301 1,278 935 $27.46
80050 General health panel 27 25 $10.26
S2900 Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) 313 235 $0.05
64636 12 12 $0.00
Q0244 Injection, casirivimab and imdevimab, 1200 mg 66 58 $0.00
Q0245 Injection, bamlanivimab and etesevimab, 2100 mg 16 12 $0.00
64494 52 40 $0.00