Medicaid Provider Spending

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

MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC.

NPI: 1629027578 · EAU CLAIRE, WI 54703 · Pharmacy · NPI assigned 05/09/2006

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

Authorized official BORTNEM, MARK controls 20+ related entities in our dataset. Read more

$16.81M
Total Medicaid Paid
1,098,373
Total Claims
896,112
Beneficiaries
434
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialBORTNEM, MARK (CFO)
NPI Enumeration Date05/09/2006

Related Entities

Other providers sharing the same authorized official: BORTNEM, MARK

ProviderCityStateTotal Paid
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC. LA CROSSE WI $13.43M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. MENOMONIE WI $9.93M
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC. LACROSSE WI $8.76M
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC. SPARTA WI $8.41M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. BARRON WI $7.81M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. EAU CLAIRE WI $7.51M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. OSSEO WI $2.14M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. BLOOMER WI $2.07M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. MENOMONIE WI $1.66M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. BARRON WI $1.11M
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. EAU CLAIRE WI $928K
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC. SPARTA WI $469K
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. MENOMONIE WI $439K
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. EAU CLAIRE WI $318K
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. BLOOMER WI $234K
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. OSSEO WI $229K
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC. ARCADIA WI $192K
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC. PRAIRIE DU CHIEN WI $177K
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. MONDOVI WI $91K
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC. BARRON WI $69K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 137,077 $1.79M
2019 129,264 $1.62M
2020 132,044 $2.45M
2021 203,585 $3.67M
2022 172,412 $2.55M
2023 163,264 $2.22M
2024 160,727 $2.52M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
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 42,096 36,281 $2.88M
99283 Emergency department visit for the evaluation and management, moderate severity 14,742 13,302 $953K
96361 Intravenous infusion, hydration; each additional hour 10,327 8,078 $880K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 20,256 17,329 $722K
99284 Emergency department visit for the evaluation and management, high severity 13,581 12,068 $625K
80053 Comprehensive metabolic panel 26,482 22,373 $587K
87507 1,393 1,333 $481K
80048 Basic metabolic panel (calcium, ionized) 24,040 20,502 $414K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 70,524 52,356 $386K
99282 Emergency department visit for the evaluation and management, low to moderate severity 4,359 4,011 $367K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 10,683 9,910 $339K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 10,670 9,902 $334K
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 30,911 26,142 $293K
74177 Computed tomography, abdomen and pelvis; with contrast material 5,511 4,987 $266K
70450 Computed tomography, head or brain; without contrast material 5,196 4,579 $251K
88305 Level IV - Surgical pathology, gross and microscopic examination 8,223 6,705 $221K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 47,581 38,419 $219K
84443 Thyroid stimulating hormone (TSH) 16,004 14,744 $175K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 4,818 4,370 $168K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 2,191 2,052 $168K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,225 1,125 $158K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 3,605 3,058 $152K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 5,887 5,525 $125K
87631 1,115 1,036 $121K
85610 14,557 8,952 $115K
87086 Culture, bacterial; quantitative colony count, urine 14,798 13,533 $113K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 4,002 3,110 $111K
64483 787 729 $105K
87480 5,645 5,166 $101K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 18,446 15,530 $98K
87660 5,645 5,166 $94K
87510 5,647 5,167 $94K
H2012 Behavioral health day treatment, per hour 1,724 206 $92K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 224 215 $91K
80061 Lipid panel 8,776 8,354 $89K
93308 879 806 $85K
71260 Computed tomography, thorax, diagnostic; with contrast material 1,915 1,752 $84K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 5,876 5,235 $81K
11721 1,977 1,936 $81K
87653 2,403 2,268 $79K
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 4,550 4,378 $77K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 6,740 5,902 $75K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 694 655 $74K
71046 Radiologic examination, chest; 2 views 6,845 6,204 $73K
87070 6,826 6,242 $73K
71275 Computed tomographic angiography, chest, with contrast material 1,381 1,228 $72K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 847 741 $69K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,634 1,534 $69K
83036 Hemoglobin; glycosylated (A1C) 10,379 9,886 $69K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 3,204 2,440 $68K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,891 1,533 $67K
82948 7,532 3,206 $67K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 1,250 950 $66K
87077 7,759 6,661 $63K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 2,186 1,250 $57K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 4,495 3,981 $56K
82728 4,936 4,675 $56K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 1,837 1,774 $55K
74176 Computed tomography, abdomen and pelvis; without contrast material 1,208 1,092 $52K
45380 Colonoscopy, flexible; with biopsy, single or multiple 452 400 $52K
93296 2,753 2,655 $50K
84484 6,139 5,062 $49K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 7,110 4,035 $49K
76705 Ultrasound, abdominal, real time with image documentation; limited 1,863 1,676 $48K
86803 3,675 3,488 $46K
84439 6,013 5,609 $45K
80306 3,114 2,775 $45K
78815 Positron emission tomography (PET) for limited area imaging 452 432 $44K
83605 6,835 5,877 $42K
81025 4,418 3,964 $42K
86780 4,555 4,248 $41K
72125 Computed tomography, cervical spine; without contrast material 2,268 2,030 $41K
80050 General health panel 1,007 835 $41K
85027 9,410 8,405 $40K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 710 400 $39K
87186 5,902 5,356 $38K
93321 624 582 $37K
95886 1,366 1,192 $37K
84702 2,402 1,985 $37K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1,638 1,556 $36K
G0378 Hospital observation service, per hour 5,358 2,665 $35K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 328 302 $35K
81001 10,919 9,761 $34K
86850 4,101 3,530 $34K
87340 3,939 3,676 $34K
82607 3,079 2,937 $34K
86480 715 663 $33K
88142 1,607 1,543 $32K
90834 Psychotherapy, 45 minutes with patient 7,807 5,613 $32K
83970 1,365 1,283 $32K
83880 2,570 2,309 $31K
86618 2,116 1,999 $31K
82947 6,046 4,504 $31K
83735 7,910 6,445 $28K
86140 7,827 6,990 $28K
82805 1,588 1,391 $28K
82565 5,746 5,094 $27K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 711 651 $27K
83690 6,834 5,984 $27K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 674 632 $27K
82077 3,136 2,689 $26K
Q3014 Telehealth originating site facility fee 4,261 3,685 $26K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 1,272 594 $25K
94060 1,030 978 $25K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 4,659 2,329 $24K
93225 866 766 $23K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,043 941 $23K
86762 1,848 1,680 $23K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 41 39 $23K
V5011 Fitting/orientation/checking of hearing aid 113 107 $22K
87103 2,400 2,113 $22K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 2,214 1,449 $21K
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 490 467 $20K
87040 4,445 2,112 $20K
71250 905 849 $20K
88342 1,320 1,187 $20K
20610 1,391 1,234 $20K
80143 1,957 1,719 $19K
80179 1,930 1,696 $19K
83550 2,977 2,831 $18K
74018 967 866 $18K
82570 4,306 3,737 $17K
72100 1,124 1,050 $16K
85379 2,867 2,586 $16K
93971 863 804 $15K
93017 654 610 $15K
76830 Ultrasound, transvaginal 579 532 $15K
93976 525 483 $14K
81003 6,119 5,624 $14K
93325 780 727 $14K
83540 3,012 2,864 $14K
82043 3,168 3,026 $13K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 3,290 3,161 $13K
82746 1,271 1,207 $13K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 9,432 6,772 $12K
97162 2,009 1,899 $12K
86481 202 186 $12K
99215 Prolong outpt/office vis 1,760 1,636 $12K
84153 909 870 $12K
72040 362 342 $12K
87999 310 258 $12K
82248 4,496 3,967 $12K
80076 1,559 1,463 $11K
84450 3,497 3,100 $11K
84460 3,048 2,702 $11K
86376 1,012 894 $10K
83516 1,103 669 $10K
84165 981 695 $9K
82784 845 739 $9K
84146 538 509 $9K
J0248 Injection, remdesivir, 1 mg 254 24 $9K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 94 78 $8K
86038 886 829 $8K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 187 176 $8K
97161 577 541 $7K
80047 322 285 $7K
86787 1,130 1,021 $7K
86706 827 788 $7K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 382 369 $7K
86900 3,525 3,019 $7K
84132 2,157 1,800 $7K
42820 Tonsillectomy and adenoidectomy; younger than age 12 17 15 $7K
70498 91 88 $7K
86901 3,514 3,016 $6K
20553 143 138 $6K
73502 1,459 1,352 $6K
73630 2,824 2,281 $6K
95812 38 36 $6K
85018 3,076 2,746 $6K
86769 362 342 $5K
94726 843 805 $5K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 686 655 $5K
80164 513 466 $5K
82950 1,160 1,095 $5K
90853 Group psychotherapy (other than of a multiple-family group) 646 293 $5K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 62 52 $5K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 1,724 1,055 $5K
70496 64 63 $5K
94729 1,018 971 $5K
G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician 274 264 $5K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 731 687 $5K
88304 645 580 $5K
67028 Intravitreal injection of a pharmacologic agent 2,223 1,751 $5K
92134 3,946 3,790 $5K
82803 300 269 $5K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 922 863 $5K
93226 748 671 $5K
87075 1,008 855 $5K
71045 Radiologic examination, chest; single view 6,770 5,897 $4K
86334 306 223 $4K
97530 Therapeutic activities, direct patient contact, each 15 minutes 546 411 $4K
80178 752 658 $4K
85652 2,311 2,146 $4K
84100 1,564 1,324 $4K
82550 871 745 $4K
73030 1,862 1,591 $4K
86364 237 219 $3K
64635 14 14 $3K
82105 300 270 $3K
G0249 Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests 765 651 $3K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 11,615 9,350 $3K
90715 670 630 $3K
73130 1,117 871 $3K
88341 101 95 $3K
95910 77 77 $3K
82310 694 608 $3K
73564 2,377 1,903 $3K
82247 431 349 $3K
73110 939 765 $3K
83521 159 149 $3K
0240U 113 100 $3K
73610 1,502 1,291 $3K
88307 141 118 $3K
88738 129 126 $3K
90837 Psychotherapy, 53 minutes with patient 998 669 $3K
93229 164 144 $3K
76770 66 66 $3K
93923 133 128 $3K
62323 13 12 $3K
96375 Therapeutic injection; each additional sequential IV push 8,465 6,547 $3K
64636 17 13 $3K
84156 974 837 $3K
72110 118 112 $3K
36415 Collection of venous blood by venipuncture 30,757 23,949 $2K
97165 205 191 $2K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 60 53 $2K
80069 575 545 $2K
99024 859 683 $2K
70486 67 61 $2K
87478 97 88 $2K
86704 206 202 $2K
84550 907 823 $2K
83001 125 119 $2K
95800 41 39 $2K
76700 Ultrasound, abdominal, real time with image documentation; complete 40 36 $2K
64493 14 13 $2K
77002 128 115 $2K
92557 203 200 $2K
86235 28 26 $2K
83615 659 590 $2K
97535 Self-care/home management training, each 15 minutes 208 147 $2K
12001 24 24 $2K
70551 Magnetic resonance imaging, brain; without contrast material 28 25 $2K
94762 27 26 $1K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 16 13 $1K
J0585 Injection, onabotulinumtoxina, 1 unit 654 427 $1K
84155 672 616 $1K
95908 31 31 $1K
82378 105 75 $1K
76882 69 61 $1K
88141 76 74 $1K
74174 16 13 $1K
82533 84 72 $1K
86696 56 50 $1K
86431 223 215 $1K
93280 97 92 $948.31
64566 20 12 $943.67
84295 262 226 $881.33
93351 14 13 $858.74
95885 53 40 $798.32
91322 179 163 $767.48
99205 Prolong outpt/office vis 170 168 $755.98
97116 102 72 $747.89
J0178 Injection, aflibercept, 1 mg 739 570 $736.91
85730 267 243 $718.55
87529 26 13 $705.72
86695 56 50 $702.14
82657 25 25 $623.54
29581 661 231 $617.25
51702 322 288 $612.74
84075 196 154 $583.78
94618 53 51 $559.25
90686 559 535 $556.59
72050 26 26 $535.01
77091 115 112 $504.08
76942 768 707 $486.55
69210 73 69 $472.03
36591 421 289 $467.03
93970 27 25 $435.06
82977 25 24 $427.44
82010 75 68 $424.80
96368 15 13 $414.29
82375 72 66 $410.35
74178 42 41 $407.52
C9257 Injection, bevacizumab, 0.25 mg 94 78 $395.51
87493 15 14 $382.76
88108 28 25 $379.06
97166 29 28 $326.18
93880 14 14 $314.74
J3490 Unclassified drugs 3,813 2,848 $308.00
51798 1,388 1,311 $307.32
85014 189 171 $246.45
90480 179 163 $245.12
64615 92 81 $241.88
94010 26 26 $231.25
87205 120 95 $228.81
82040 79 75 $228.64
87206 57 40 $202.17
20552 12 12 $201.15
96367 24 16 $192.18
0097U 741 703 $179.72
98968 26 20 $179.63
90832 Psychotherapy, 30 minutes with patient 42 41 $179.62
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit 44 43 $178.76
96376 2,532 1,868 $175.20
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 4,863 2,956 $159.37
36416 7,738 4,450 $159.17
G0379 Direct admission of patient for hospital observation care 19 16 $152.46
82140 14 12 $136.81
99495 106 105 $133.82
74019 40 38 $121.48
83050 70 65 $120.26
84560 34 28 $120.24
86705 12 12 $118.88
87102 31 25 $117.11
J2704 Injection, propofol, 10 mg 21,946 7,858 $109.38
84520 38 37 $101.93
76376 586 544 $92.53
84145 29 25 $91.00
90792 Psychiatric diagnostic evaluation with medical services 79 79 $89.21
73080 161 139 $77.53
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 609 576 $76.47
77065 Tomosynthesis, mammo 30 28 $71.30
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,137 956 $68.90
72170 76 65 $68.69
97035 56 31 $52.25
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 11,607 6,198 $51.16
90656 26 24 $49.22
90791 Psychiatric diagnostic evaluation 28 28 $38.85
C1769 Guide wire 1,470 1,295 $33.95
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 37 37 $33.83
83718 49 48 $32.59
J1885 Injection, ketorolac tromethamine, per 15 mg 9,243 7,083 $31.18
J1644 Injection, heparin sodium, per 1000 units 1,972 1,125 $30.56
73590 82 67 $30.41
90662 459 437 $27.93
J2250 Injection, midazolam hydrochloride, per 1 mg 9,259 7,915 $21.95
J0171 Injection, adrenalin, epinephrine, 0.1 mg 405 219 $21.80
0764T 45 42 $21.42
J2270 Injection, morphine sulfate, up to 10 mg 1,177 835 $21.24
J1040 Injection, methylprednisolone acetate, 80 mg 954 893 $20.30
J2405 Injection, ondansetron hydrochloride, per 1 mg 11,372 8,658 $20.08
11102 14 12 $18.99
J2795 Injection, ropivacaine hydrochloride, 1 mg 2,755 1,299 $16.78
J1100 Injection, dexamethasone sodium phosphate, 1 mg 10,185 7,255 $15.86
82465 36 35 $12.74
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 6,646 5,114 $11.55
J7050 Infusion, normal saline solution, 250 cc 809 527 $10.94
J7030 Infusion, normal saline solution , 1000 cc 3,341 2,576 $10.86
99496 92 88 $8.24
0004A 38 32 $5.78
J1170 Injection, hydromorphone, up to 4 mg 3,360 2,317 $5.70
J0696 Injection, ceftriaxone sodium, per 250 mg 1,223 932 $3.57
0124A 79 78 $2.02
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,957 1,535 $1.20
J2060 Injection, lorazepam, 2 mg 990 739 $0.95
J1596 Injection, glycopyrrolate, 0.1 mg 209 174 $0.91
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 901 523 $0.56
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 770 690 $0.25
J2765 Injection, metoclopramide hcl, up to 10 mg 417 369 $0.00
A9585 Injection, gadobutrol, 0.1 ml 767 395 $0.00
J1010 Injection, methylprednisolone acetate, 1 mg 276 238 $0.00
J0690 Injection, cefazolin sodium, 500 mg 4,363 3,642 $0.00
J1815 Injection, insulin, per 5 units 34 26 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 5,566 4,270 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 625 441 $0.00
J0131 Injection, acetaminophen, not otherwise specified,10 mg 848 696 $0.00
A9270 Non-covered item or service 9,666 7,170 $0.00
J2370 Injection, phenylephrine hcl, up to 1 ml 544 503 $0.00
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 924 811 $0.00
J1940 Injection, furosemide, up to 20 mg 133 94 $0.00
0754T 41 36 $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 108 85 $0.00
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 80 76 $0.00
J1030 Injection, methylprednisolone acetate, 40 mg 97 92 $0.00
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 91 67 $0.00
G0008 Administration of influenza virus vaccine 823 806 $0.00
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 100 91 $0.00
99153 Mod sedat endo service >5yrs 19 18 $0.00
C1889 Implantable/insertable device, not otherwise classified 25 25 $0.00
88300 41 39 $0.00
G8981 Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals 21 12 $0.00
73552 15 13 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 40 27 $0.00
V2632 Posterior chamber intraocular lens 18 15 $0.00
G8998 Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting 12 12 $0.00
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 26 17 $0.00
G8991 Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 14 12 $0.00
92567 12 12 $0.00
G8982 Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 21 12 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 69 39 $0.00
73090 17 15 $0.00
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 14 12 $0.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 18 12 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 47 36 $0.00
J1756 Injection, iron sucrose, 1 mg 24 12 $0.00
0753T 2,394 1,959 $0.00
J7120 Ringers lactate infusion, up to 1000 cc 2,306 2,093 $0.00
J1650 Injection, enoxaparin sodium, 10 mg 334 171 $0.00
0752T 286 262 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 510 391 $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 373 323 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 343 307 $0.00
0760T 241 218 $0.00
C1887 Catheter, guiding (may include infusion/perfusion capability) 31 25 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 281 211 $0.00
17110 15 15 $0.00
77080 141 138 $0.00
73140 23 17 $0.00
A6250 Skin sealants, protectants, moisturizers, ointments, any type, any size 39 39 $0.00
31575 12 12 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 312 281 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 27 25 $0.00
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 58 53 $0.00
J2550 Injection, promethazine hcl, up to 50 mg 49 37 $0.00
0054A 30 30 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 77 69 $0.00
0761T 46 36 $0.00
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg 19 13 $0.00
C2625 Stent, non-coronary, temporary, with delivery system 14 12 $0.00
J8499 Prescription drug, oral, non chemotherapeutic, nos 1,160 475 $0.00
0202U Oncology (prostate), multianalyte, gene expression profiling 28 27 $0.00
90472 Immunization administration, each additional vaccine (list separately) 12 12 $0.00
G8997 Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 28 26 $0.00
G8984 Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals 16 14 $0.00
76937 14 12 $0.00
J1171 Injection, hydromorphone, 0.1 mg 109 66 $0.00
C9113 Injection, pantoprazole sodium, per vial 25 15 $0.00
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 17 14 $0.00
0003A 16 14 $0.00
J3370 Injection, vancomycin hcl, 500 mg 20 12 $0.00
G8985 Carrying, moving and handling objects, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 16 15 $0.00
G8996 Swallowing functional limitation, current status at therapy episode outset and at reporting intervals 13 13 $0.00
76642 18 18 $0.00