Medicaid Provider Spending

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

ST. MARY MEDICAL CENTER

NPI: 1710109186 · APPLE VALLEY, CA 92307 · General Acute Care Hospital · NPI assigned 05/03/2007

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

Authorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more

$52.36M
Total Medicaid Paid
1,987,799
Total Claims
1,646,024
Beneficiaries
380
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialANDERSON, DONALD (ASSISTANT SECRETARY ENROLLMENTS)
Parent OrganizationST JOSEPH HEALTH SYSTEM
NPI Enumeration Date05/03/2007

Related Entities

Other providers sharing the same authorized official: ANDERSON, DONALD

ProviderCityStateTotal Paid
PROVIDENCE HEALTH & SERVICES WASHINGTON ANCHORAGE AK $161.45M
KADLEC REGIONAL MEDICAL CENTER RICHLAND WA $151.60M
SWEDISH EDMONDS EDMONDS WA $30.06M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC EUREKA CA $28.68M
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA TORRANCE CA $27.29M
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA SAN PEDRO CA $24.26M
PROVIDENCE HEALTH & SERVICES - WASHINGTON TUKWILA WA $21.98M
SWEDISH HEALTH SERVICES SEATTLE WA $21.06M
PROVIDENCE HEALTH & SERVICES WASHINGTON KODIAK AK $11.39M
SWEDISH HEALTH SERVICES SEATTLE WA $11.08M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC FORTUNA CA $8.55M
COLLABRIA CARE NAPA CA $8.20M
PROVIDENCE HEALTH & SERVICES OREGON SEASIDE OR $8.01M
PROVIDENCE HEALTH & SERVICES- WASHINGTON SPOKANE WA $8.01M
HOSPICE OF LUBBOCK INC LUBBOCK TX $6.48M
PROVIDENCE SAINT JOHN'S HEALTH CENTER SANTA MONICA CA $5.52M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.55M
COLLABRIA CARE NAPA CA $4.05M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.01M
METHODIST HOSPITAL PLAINVIEW TEXAS PLAINVIEW TX $4.00M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 278,217 $6.73M
2019 296,662 $7.66M
2020 258,137 $6.56M
2021 245,837 $6.31M
2022 281,063 $7.53M
2023 327,818 $8.72M
2024 300,065 $8.85M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0450 Emergency room services 130,142 113,500 $6.25M
99283 Emergency department visit for the evaluation and management, moderate severity 85,455 76,220 $4.22M
70450 Computed tomography, head or brain; without contrast material 17,957 17,267 $2.66M
74177 Computed tomography, abdomen and pelvis; with contrast material 11,023 10,683 $2.06M
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 7,118 3,580 $1.56M
80053 Comprehensive metabolic panel 103,067 91,282 $1.47M
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 26,431 24,957 $1.45M
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 11,476 11,110 $1.45M
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 49,802 45,427 $1.34M
85025 Blood count; complete (CBC), automated, and automated differential WBC count 123,339 106,949 $1.26M
74176 Computed tomography, abdomen and pelvis; without contrast material 12,931 12,550 $1.20M
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 41,465 34,637 $1.10M
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 17,957 16,136 $978K
Z7502 22,435 22,138 $844K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 7,541 7,037 $777K
96375 Therapeutic injection; each additional sequential IV push 21,507 18,041 $756K
15275 647 263 $740K
84484 51,660 37,913 $737K
72125 Computed tomography, cervical spine; without contrast material 3,896 3,815 $708K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 9,222 8,818 $630K
71275 Computed tomographic angiography, chest, with contrast material 3,519 3,421 $583K
99499 6,859 5,742 $564K
84702 34,857 32,159 $552K
76705 Ultrasound, abdominal, real time with image documentation; limited 10,498 10,145 $544K
71046 Radiologic examination, chest; 2 views 28,751 27,505 $527K
96361 Intravenous infusion, hydration; each additional hour 17,047 15,426 $508K
0206 52 43 $393K
11043 954 650 $357K
0360 2,514 2,340 $354K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 2,596 2,545 $352K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 6,012 5,844 $346K
93975 1,770 1,719 $343K
83690 37,146 34,615 $342K
71045 Radiologic examination, chest; single view 35,870 33,843 $340K
93971 3,670 3,566 $340K
72131 1,977 1,947 $327K
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 4,350 4,211 $323K
83880 15,545 14,585 $321K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 4,830 1,907 $290K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 15,009 12,094 $290K
81001 61,206 57,189 $278K
99284 Emergency department visit for the evaluation and management, high severity 3,772 3,533 $275K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 4,462 4,334 $275K
G0378 Hospital observation service, per hour 5,637 3,106 $271K
70551 Magnetic resonance imaging, brain; without contrast material 747 734 $260K
99070 138,718 60,524 $255K
Q4133 Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure) 363 150 $245K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 1,882 1,872 $243K
76801 4,696 4,194 $237K
80048 Basic metabolic panel (calcium, ionized) 20,760 17,600 $229K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 4,023 3,640 $207K
87040 12,626 8,536 $204K
70496 1,493 1,454 $203K
49083 1,848 779 $195K
93970 1,217 1,183 $194K
83605 12,320 9,745 $185K
76830 Ultrasound, transvaginal 3,072 3,000 $180K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 3,765 3,220 $179K
70486 1,180 1,151 $177K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 3,660 3,614 $173K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 13,896 13,343 $171K
0761 5,073 3,125 $168K
97530 Therapeutic activities, direct patient contact, each 15 minutes 4,038 1,654 $167K
Z9725 3,718 3,683 $160K
93458 103 103 $159K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 3,415 3,330 $159K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 712 691 $156K
70498 1,549 1,510 $152K
J3490 Unclassified drugs 81,348 39,623 $145K
11044 127 84 $130K
85379 9,679 9,299 $130K
87631 2,647 2,622 $129K
84443 Thyroid stimulating hormone (TSH) 6,225 5,945 $128K
71260 Computed tomography, thorax, diagnostic; with contrast material 569 557 $125K
83735 15,494 12,755 $124K
0710 4,515 4,248 $124K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 2,062 1,935 $116K
85610 21,903 20,285 $115K
87086 Culture, bacterial; quantitative colony count, urine 14,381 13,717 $114K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 8,365 7,659 $112K
85730 15,961 14,773 $110K
0240U 906 896 $109K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 604 580 $107K
84703 10,099 9,656 $103K
73630 4,610 4,421 $100K
90715 2,924 2,883 $97K
73130 4,183 3,979 $97K
76770 1,423 1,400 $95K
73610 3,906 3,776 $91K
73562 4,108 3,927 $86K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 3,932 1,124 $81K
73030 3,339 3,180 $80K
74018 4,814 4,655 $80K
0762 1,450 613 $77K
88305 Level IV - Surgical pathology, gross and microscopic examination 2,986 2,876 $76K
P9016 Red blood cells, leukocytes reduced, each unit 374 326 $76K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 4,113 2,717 $74K
J3010 Injection, fentanyl citrate, 0.1 mg 13,076 11,187 $72K
82948 13,992 6,563 $71K
82962 10,266 5,684 $67K
84439 5,980 5,650 $67K
86901 10,660 9,807 $66K
73110 2,801 2,668 $65K
93454 39 39 $64K
72100 2,338 2,303 $60K
70491 275 266 $56K
99238 Hospital discharge day management, 30 minutes or less 1,871 1,864 $56K
96367 1,544 1,448 $54K
99152 1,689 1,617 $53K
87186 3,969 3,757 $51K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 3,191 3,101 $51K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 3,173 3,088 $50K
76870 935 885 $49K
86141 5,754 5,478 $49K
96376 2,324 1,260 $48K
86850 5,392 5,160 $48K
Z7610 10,050 6,185 $47K
73080 1,844 1,787 $45K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 988 933 $44K
86900 10,613 9,803 $44K
73502 1,552 1,472 $42K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 1,078 1,032 $41K
86923 274 266 $41K
82805 1,095 1,028 $40K
93017 717 693 $39K
85027 4,995 3,960 $38K
J2785 Injection, regadenoson, 0.1 mg 332 317 $37K
73590 2,100 2,010 $37K
15271 30 13 $37K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 15,486 14,678 $36K
73090 1,864 1,785 $35K
J1885 Injection, ketorolac tromethamine, per 15 mg 21,507 20,225 $35K
71250 192 191 $35K
87077 4,595 4,329 $34K
72040 1,365 1,337 $33K
83036 Hemoglobin; glycosylated (A1C) 2,950 2,837 $32K
74021 1,360 1,317 $32K
81025 4,411 4,327 $31K
99217 390 386 $31K
J2270 Injection, morphine sulfate, up to 10 mg 14,459 11,361 $31K
82550 3,728 3,493 $31K
80061 Lipid panel 2,517 2,415 $30K
88304 2,355 2,263 $29K
J2405 Injection, ondansetron hydrochloride, per 1 mg 25,970 22,132 $28K
81003 9,402 8,565 $28K
72128 227 225 $28K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 121 121 $28K
59025 Fetal non-stress test 1,367 665 $27K
82728 1,692 1,579 $27K
J0696 Injection, ceftriaxone sodium, per 250 mg 11,089 9,420 $26K
82803 927 888 $25K
71101 619 603 $24K
76937 1,574 1,428 $23K
V2632 Posterior chamber intraocular lens 216 203 $23K
87070 2,240 1,999 $22K
36415 Collection of venous blood by venipuncture 7,460 5,199 $22K
47562 68 64 $22K
99281 Emergency department visit for the evaluation and management, self-limited or minor 594 538 $21K
12001 1,127 1,116 $21K
P9047 Infusion, albumin (human), 25%, 50 ml 346 144 $21K
87210 3,308 3,166 $20K
87430 1,406 1,351 $17K
80076 1,701 1,608 $17K
82010 1,567 1,465 $17K
99221 153 93 $17K
82140 1,167 1,044 $16K
J1815 Injection, insulin, per 5 units 5,312 2,591 $16K
J2250 Injection, midazolam hydrochloride, per 1 mg 8,512 7,865 $16K
87081 2,083 2,006 $16K
V5008 Hearing screening 364 351 $15K
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 1,796 1,765 $15K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 3,394 3,089 $14K
10060 813 774 $14K
87807 2,030 1,920 $14K
J1650 Injection, enoxaparin sodium, 10 mg 5,085 2,642 $14K
J7030 Infusion, normal saline solution , 1000 cc 3,599 3,188 $14K
S0164 Injection, pantoprazole sodium, 40 mg 3,020 2,138 $14K
83615 1,762 1,659 $14K
87205 2,719 2,392 $14K
J1170 Injection, hydromorphone, up to 4 mg 6,515 4,808 $13K
76700 Ultrasound, abdominal, real time with image documentation; complete 201 176 $13K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 39 38 $13K
J2704 Injection, propofol, 10 mg 5,991 5,562 $13K
0250 4,103 2,448 $12K
99199 Unlisted special service, procedure or report 294 277 $12K
84100 2,599 2,163 $12K
J2765 Injection, metoclopramide hcl, up to 10 mg 7,324 6,909 $12K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,151 3,047 $12K
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 736 614 $12K
J0690 Injection, cefazolin sodium, 500 mg 5,084 4,223 $12K
12011 581 576 $12K
73060 672 646 $12K
59425 192 162 $11K
29515 1,231 1,202 $11K
29125 1,646 1,608 $11K
92523 146 143 $11K
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 3,433 3,045 $10K
99153 Mod sedat endo service >5yrs 991 950 $10K
A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml 636 461 $10K
J1644 Injection, heparin sodium, per 1000 units 5,010 2,922 $10K
Q0144 Azithromycin dihydrate, oral, capsules/powder, 1 gram 1,071 1,008 $10K
76999 102 102 $9K
87075 939 815 $9K
73552 471 440 $9K
97533 486 225 $9K
J1953 Injection, levetiracetam, 10 mg 983 761 $9K
88342 348 338 $9K
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 2,418 1,639 $8K
0361 66 63 $8K
0272 671 592 $8K
S0020 Injection, bupivicaine hydrochloride, 30 ml 1,642 1,513 $7K
J1200 Injection, diphenhydramine hcl, up to 50 mg 5,789 5,268 $7K
85652 2,263 2,194 $7K
84550 1,222 1,071 $7K
87147 1,306 1,189 $7K
J0500 Injection, dicyclomine hcl, up to 20 mg 302 289 $7K
71020 266 238 $7K
76819 Fetal biophysical profile; without non-stress testing 143 125 $7K
J3370 Injection, vancomycin hcl, 500 mg 1,121 805 $6K
82731 148 144 $6K
73140 401 380 $6K
82570 1,051 866 $6K
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 89 79 $5K
J0330 Injection, succinylcholine chloride, up to 20 mg 1,303 1,276 $5K
94664 754 376 $5K
70360 328 314 $5K
72070 190 185 $5K
96368 248 241 $5K
J0360 Injection, hydralazine hcl, up to 20 mg 1,590 1,222 $5K
94799 175 163 $5K
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 1,858 1,771 $5K
Z6410 540 461 $5K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 17 17 $4K
72170 249 246 $4K
74019 189 171 $4K
12002 250 246 $4K
0270 1,859 1,111 $4K
J7120 Ringers lactate infusion, up to 1000 cc 488 476 $4K
Z6500 27 27 $4K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 26 26 $4K
G0500 Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) 110 110 $4K
97161 115 113 $4K
J2060 Injection, lorazepam, 2 mg 3,623 2,846 $4K
97116 280 212 $3K
J7050 Infusion, normal saline solution, 250 cc 2,353 1,287 $3K
29505 345 341 $3K
85018 1,071 942 $3K
J3475 Injection, magnesium sulfate, per 500 mg 1,021 890 $3K
36600 253 236 $3K
J2175 Injection, meperidine hydrochloride, per 100 mg 589 422 $3K
97535 Self-care/home management training, each 15 minutes 326 170 $3K
J0561 Injection, penicillin g benzathine, 100,000 units 80 74 $3K
J2919 Injection, methylprednisolone sodium succinate, 5 mg 616 537 $3K
J1940 Injection, furosemide, up to 20 mg 1,788 1,055 $3K
C1769 Guide wire 156 154 $2K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 99 99 $2K
45380 Colonoscopy, flexible; with biopsy, single or multiple 91 80 $2K
85049 992 967 $2K
72072 72 71 $2K
71010 139 137 $2K
J0171 Injection, adrenalin, epinephrine, 0.1 mg 637 574 $2K
J3105 Injection, terbutaline sulfate, up to 1 mg 679 527 $2K
J0456 Injection, azithromycin, 500 mg 827 556 $2K
J2795 Injection, ropivacaine hydrochloride, 1 mg 432 311 $2K
86308 280 274 $2K
J1836 Injection, metronidazole, 10 mg 237 158 $2K
84156 710 586 $2K
82077 45 43 $2K
94760 456 275 $2K
84132 337 319 $2K
S0077 Injection, clindamycin phosphate, 300 mg 192 172 $2K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 77 29 $1K
J8540 Dexamethasone, oral, 0.25 mg 1,056 987 $1K
58558 12 12 $1K
85384 111 105 $1K
74022 28 28 $1K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 94 93 $1K
94729 28 28 $1K
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 2,807 2,573 $1K
0353U 25 25 $1K
94726 28 28 $1K
29105 132 127 $1K
J0780 Injection, prochlorperazine, up to 10 mg 310 300 $1K
51702 83 74 $1K
82330 58 57 $996.86
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 65 64 $980.53
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 12 12 $974.05
88307 26 26 $955.36
86920 14 12 $952.90
74000 58 42 $935.54
97799 92 12 $918.87
J3480 Injection, potassium chloride, per 2 meq 624 452 $870.03
42820 Tonsillectomy and adenoidectomy; younger than age 12 16 14 $865.16
J0694 Injection, cefoxitin sodium, 1 gm 132 101 $861.23
A4217 Sterile water/saline, 500 ml 152 134 $855.90
74020 28 26 $849.52
80074 12 12 $797.42
J0688 Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg 664 635 $756.34
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 684 627 $740.66
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 27 14 $735.95
J7510 Prednisolone oral, per 5 mg 955 936 $709.59
0637 452 238 $698.86
S0028 Injection, famotidine, 20 mg 572 509 $660.32
J2790 Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) 12 12 $658.20
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 210 202 $643.95
A0429 Ambulance service, basic life support, emergency transport (bls-emergency) 20 18 $595.20
93990 14 12 $583.40
82150 72 68 $574.45
82248 84 77 $562.55
J2359 Injection, olanzapine, 0.5 mg 35 25 $561.50
J2370 Injection, phenylephrine hcl, up to 1 ml 255 248 $544.18
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 2,675 2,096 $535.00
0391 18 17 $488.38
J0692 Injection, cefepime hydrochloride, 500 mg 130 93 $479.54
J1596 Injection, glycopyrrolate, 0.1 mg 254 254 $451.70
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 158 158 $447.19
A9540 Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries 16 16 $444.84
84145 25 25 $439.34
0258 710 584 $427.91
0636 147 76 $423.64
82272 345 329 $422.44
J2470 Injection, pantoprazole sodium, 40 mg 257 159 $386.41
99156 17 14 $381.66
J0595 Injection, butorphanol tartrate, 1 mg 65 58 $360.66
90384 13 13 $358.01
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 99 72 $342.33
88302 34 24 $335.58
Z6400 27 27 $294.35
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 1,645 1,614 $285.56
84295 45 44 $267.51
11045 188 120 $247.55
83550 30 28 $220.95
73000 12 12 $219.67
J3411 Injection, thiamine hcl, 100 mg 95 66 $217.68
82553 15 14 $216.62
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 123 111 $212.14
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 2,331 1,898 $205.13
73120 13 13 $203.19
82947 42 41 $202.80
73660 13 13 $202.13
83540 31 29 $187.75
82247 26 24 $178.23
94200 13 13 $169.32
36410 59 57 $168.98
0410 33 28 $146.17
82270 44 42 $140.13
86592 26 26 $130.58
C9113 Injection, pantoprazole sodium, per vial 65 46 $130.30
82607 14 13 $115.85
J0736 Injection, clindamycin phosphate, 300 mg 38 36 $111.07
29130 15 15 $84.00
87340 12 12 $82.17
J2550 Injection, promethazine hcl, up to 50 mg 30 27 $63.82
83986 13 12 $59.36
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 41 39 $59.27
Q4051 Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) 190 98 $49.61
J1956 Injection, levofloxacin, 250 mg 70 48 $47.94
J1921 Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg 20 16 $45.88
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 61 61 $28.25
J1171 Injection, hydromorphone, 0.1 mg 114 95 $28.02
J1630 Injection, haloperidol, up to 5 mg 26 25 $19.64
J1920 Injection, labetalol hydrochloride, 5 mg 75 59 $18.04
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 17 16 $14.93
C1887 Catheter, guiding (may include infusion/perfusion capability) 32 32 $0.00
0460 32 29 $0.00
0730 64 57 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 69 67 $0.00
0300 82 72 $0.00
84112 20 20 $0.00
76818 55 47 $0.00
C1729 Catheter, drainage 58 26 $0.00
0301 82 72 $0.00
94762 50 29 $0.00
0305 27 24 $0.00
0306 46 40 $0.00
80050 General health panel 260 106 $0.00
A9270 Non-covered item or service 321 79 $0.00
0324 78 68 $0.00
P9612 Catheterization for collection of specimen, single patient, all places of service 32 26 $0.00
36416 24 17 $0.00