NPI: 1871656082 · MILWAUKEE, WI 53211 · General Acute Care Hospital · NPI assigned 12/18/2006
Authorized official MCCULLOUGH, MICHAEL controls 20+ related entities in our dataset. Read more
| Authorized Official | MCCULLOUGH, MICHAEL (CFO) |
| NPI Enumeration Date | 12/18/2006 |
Other providers sharing the same authorized official: MCCULLOUGH, MICHAEL
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 499,671 | $10.45M |
| 2019 | 474,096 | $9.29M |
| 2020 | 373,832 | $8.17M |
| 2021 | 434,948 | $8.65M |
| 2022 | 412,142 | $9.04M |
| 2023 | 498,615 | $10.68M |
| 2024 | 350,981 | $8.26M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 78,459 | 66,775 | $4.83M |
| 96361 | Intravenous infusion, hydration; each additional hour | 35,911 | 27,332 | $4.41M |
| 99284 | Emergency department visit for the evaluation and management, high severity | 67,880 | 56,652 | $3.61M |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 50,009 | 40,140 | $2.30M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 43,585 | 35,501 | $2.21M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 43,707 | 35,236 | $2.04M |
| 80053 | Comprehensive metabolic panel | 104,099 | 78,837 | $1.98M |
| 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 | 23,780 | 19,726 | $1.90M |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 38,589 | 30,170 | $1.29M |
| 80048 | Basic metabolic panel (calcium, ionized) | 57,642 | 42,240 | $1.12M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 16,989 | 14,512 | $1.12M |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 38,607 | 30,221 | $1.11M |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 133,583 | 96,988 | $1.08M |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 13,703 | 11,173 | $1.01M |
| 70450 | Computed tomography, head or brain; without contrast material | 14,583 | 12,419 | $977K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 18,536 | 15,129 | $957K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 12,883 | 7,676 | $941K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 32,854 | 23,104 | $890K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 20,054 | 14,863 | $885K |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | 31,384 | 24,296 | $837K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 11,737 | 10,000 | $776K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 11,245 | 8,825 | $714K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 15,360 | 13,650 | $664K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 8,083 | 7,159 | $640K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 31,294 | 10,608 | $638K |
| 59025 | Fetal non-stress test | 7,644 | 4,390 | $588K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 3,225 | 2,682 | $531K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 5,299 | 4,734 | $518K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 5,419 | 4,564 | $517K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 4,051 | 2,196 | $462K |
| J9271 | Injection, pembrolizumab, 1 mg | 359 | 202 | $453K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 6,358 | 5,455 | $449K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 12,518 | 7,641 | $444K |
| 87081 | 17,163 | 14,992 | $430K | |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 12,078 | 1,898 | $413K |
| 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 | 10,606 | 8,213 | $401K |
| 80061 | Lipid panel | 31,963 | 26,274 | $387K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 53,793 | 40,524 | $382K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 2,366 | 1,993 | $382K |
| 96367 | 5,966 | 2,688 | $378K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 27,844 | 22,269 | $356K |
| 81025 | 38,591 | 32,168 | $341K | |
| 82962 | 28,597 | 16,570 | $336K | |
| 84443 | Thyroid stimulating hormone (TSH) | 30,868 | 24,958 | $324K |
| 76801 | 7,989 | 6,631 | $318K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 4,890 | 3,964 | $311K |
| 71275 | Computed tomographic angiography, chest, with contrast material | 3,994 | 3,371 | $295K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 1,801 | 1,544 | $290K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 7,778 | 3,729 | $285K |
| 84484 | 31,825 | 23,611 | $283K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 1,997 | 1,601 | $279K |
| 87634 | 5,180 | 4,645 | $276K | |
| 83880 | 12,305 | 9,734 | $267K | |
| D1206 | Topical application of fluoride varnish | 22,303 | 21,130 | $265K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 14,579 | 11,548 | $262K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 17,324 | 6,483 | $261K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 4,213 | 3,666 | $260K |
| D1351 | Sealant - per tooth | 17,249 | 5,556 | $255K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 11,390 | 9,584 | $249K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 5,291 | 4,675 | $237K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 10,567 | 4,407 | $228K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 999 | 813 | $220K |
| 83036 | Hemoglobin; glycosylated (A1C) | 33,007 | 26,123 | $210K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 821 | 739 | $205K |
| 84702 | 9,614 | 7,032 | $198K | |
| 76830 | Ultrasound, transvaginal | 5,085 | 4,511 | $198K |
| 81001 | 41,828 | 34,980 | $193K | |
| 93356 | 2,361 | 2,046 | $192K | |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 8,851 | 6,625 | $186K |
| D0191 | 18,861 | 18,023 | $178K | |
| 99215 | Prolong outpt/office vis | 4,602 | 3,454 | $177K |
| G0378 | Hospital observation service, per hour | 11,424 | 8,024 | $177K |
| P9016 | Red blood cells, leukocytes reduced, each unit | 686 | 453 | $169K |
| 85027 | 29,956 | 23,215 | $168K | |
| 81420 | Fetal chromosomal aneuploidy genomic sequence analysis panel | 430 | 349 | $163K |
| 96415 | 1,973 | 1,260 | $152K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 6,100 | 5,574 | $150K |
| 83690 | 27,101 | 22,426 | $148K | |
| 85610 | 20,731 | 15,227 | $148K | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 5,821 | 4,418 | $146K |
| 87077 | 11,267 | 8,990 | $146K | |
| S9480 | Intensive outpatient psychiatric services, per diem | 2,989 | 452 | $139K |
| 76642 | 3,732 | 2,929 | $137K | |
| 80081 | 2,028 | 1,263 | $135K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 2,647 | 2,237 | $134K |
| 86901 | 11,058 | 8,895 | $134K | |
| 12001 | 1,608 | 1,480 | $133K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 8,557 | 7,742 | $132K |
| 72125 | Computed tomography, cervical spine; without contrast material | 4,186 | 3,661 | $130K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 3,577 | 3,111 | $130K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 4,351 | 3,763 | $129K |
| 82728 | 8,907 | 7,305 | $129K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 6,466 | 2,579 | $126K |
| 86850 | 8,394 | 6,628 | $126K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 2,541 | 2,151 | $123K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 3,048 | 1,128 | $120K |
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education | 2,713 | 378 | $117K |
| 86780 | 12,308 | 9,674 | $117K | |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 1,335 | 1,084 | $115K |
| 76819 | Fetal biophysical profile; without non-stress testing | 7,000 | 5,094 | $115K |
| 71046 | Radiologic examination, chest; 2 views | 16,670 | 14,271 | $113K |
| 87070 | 7,273 | 5,799 | $112K | |
| 86481 | 1,571 | 1,349 | $108K | |
| 86803 | 10,216 | 8,326 | $106K | |
| 97162 | 4,384 | 3,563 | $104K | |
| 70496 | 1,388 | 1,150 | $97K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 3,153 | 2,738 | $96K |
| 71250 | 3,117 | 2,719 | $95K | |
| 70498 | 1,430 | 1,162 | $93K | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 5,830 | 4,949 | $93K |
| 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 | 8,132 | 6,794 | $93K |
| 77063 | Screening digital breast tomosynthesis, bilateral | 5,981 | 5,457 | $91K |
| 90791 | Psychiatric diagnostic evaluation | 2,588 | 1,829 | $90K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 570 | 477 | $88K |
| 87210 | 8,361 | 7,229 | $87K | |
| 93971 | 2,686 | 2,365 | $83K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 1,312 | 1,110 | $82K |
| 83735 | 20,741 | 13,253 | $82K | |
| 78815 | Positron emission tomography (PET) for limited area imaging | 547 | 418 | $82K |
| 93017 | 2,256 | 1,840 | $82K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 24,023 | 17,670 | $82K |
| 82565 | 6,352 | 4,768 | $79K | |
| 82607 | 6,794 | 5,514 | $79K | |
| 93970 | 1,942 | 1,670 | $78K | |
| 12011 | 898 | 825 | $77K | |
| 84153 | 4,510 | 3,822 | $75K | |
| 80076 | 7,165 | 6,217 | $74K | |
| 83605 | 9,366 | 7,316 | $74K | |
| 81003 | 22,342 | 18,615 | $72K | |
| 70486 | 2,103 | 1,893 | $72K | |
| 90834 | Psychotherapy, 45 minutes with patient | 2,971 | 1,274 | $72K |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 1,181 | 1,055 | $71K |
| 80047 | 1,570 | 1,399 | $70K | |
| 80143 | 4,083 | 3,323 | $65K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 5,972 | 4,691 | $64K |
| D1120 | Prophylaxis - child | 3,172 | 2,987 | $63K |
| 87186 | 9,320 | 7,560 | $61K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 1,125 | 717 | $60K |
| 10060 | 804 | 697 | $56K | |
| 90837 | Psychotherapy, 53 minutes with patient | 2,023 | 916 | $55K |
| 84439 | 6,708 | 5,310 | $52K | |
| 77066 | Tomosynthesis, mammo | 2,064 | 1,847 | $51K |
| 85379 | 6,729 | 5,735 | $51K | |
| 87340 | 6,317 | 5,041 | $51K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 1,099 | 1,002 | $50K |
| 94060 | 1,578 | 1,383 | $49K | |
| 85007 | 13,848 | 10,764 | $48K | |
| 82950 | 3,977 | 3,105 | $47K | |
| 80050 | General health panel | 2,043 | 1,524 | $45K |
| 97803 | 4,585 | 4,112 | $44K | |
| 83970 | 1,803 | 1,428 | $43K | |
| 87040 | 3,949 | 3,074 | $43K | |
| 80179 | 3,968 | 3,251 | $42K | |
| 73630 | 6,325 | 5,382 | $42K | |
| 86480 | 717 | 605 | $41K | |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 970 | 641 | $41K |
| 82746 | 4,405 | 3,630 | $40K | |
| 96417 | 1,002 | 522 | $40K | |
| 83655 | 3,655 | 2,707 | $39K | |
| 87147 | 6,963 | 5,581 | $38K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 12,345 | 9,783 | $38K |
| 83615 | 7,577 | 5,089 | $38K | |
| 86762 | 3,052 | 2,447 | $38K | |
| 77336 | 1,723 | 592 | $37K | |
| 36430 | 523 | 362 | $37K | |
| 12002 | 451 | 409 | $37K | |
| 70491 | 565 | 483 | $36K | |
| 97163 | 1,142 | 1,006 | $36K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 52,403 | 41,730 | $35K |
| 97161 | 1,753 | 1,369 | $35K | |
| 29581 | 753 | 191 | $35K | |
| 83550 | 6,348 | 5,131 | $34K | |
| 76770 | 844 | 743 | $34K | |
| 76536 | 946 | 838 | $34K | |
| 90715 | 4,999 | 4,047 | $34K | |
| 82570 | 7,887 | 5,826 | $34K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1,701 | 1,599 | $33K |
| 87653 | 1,269 | 1,088 | $33K | |
| 87522 | Neg quan hep c or qual rna | 993 | 792 | $33K |
| 74018 | 3,568 | 3,013 | $32K | |
| 86900 | 11,055 | 8,899 | $32K | |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 850 | 697 | $31K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1,194 | 956 | $30K |
| 86592 | 2,025 | 1,526 | $30K | |
| 83540 | 6,848 | 5,526 | $29K | |
| 19083 | 116 | 94 | $29K | |
| 82043 | 6,298 | 5,068 | $28K | |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 1,089 | 206 | $28K |
| 77065 | Tomosynthesis, mammo | 1,459 | 1,246 | $28K |
| 86140 | 6,026 | 4,813 | $27K | |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1,208 | 943 | $26K |
| 96523 | 1,003 | 649 | $25K | |
| 84550 | 5,903 | 4,441 | $25K | |
| 97802 | 2,260 | 1,882 | $25K | |
| 82550 | 4,617 | 3,591 | $25K | |
| 97116 | 2,648 | 1,085 | $24K | |
| J2323 | Injection, natalizumab, 1 mg | 48 | 38 | $24K |
| 77062 | 1,566 | 1,438 | $23K | |
| 84145 | 1,540 | 1,228 | $22K | |
| 84156 | 2,984 | 2,078 | $22K | |
| 85652 | 5,257 | 4,345 | $21K | |
| 86706 | 2,528 | 2,022 | $21K | |
| 85014 | 3,966 | 2,891 | $21K | |
| 94729 | 1,890 | 1,681 | $21K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 44,303 | 35,488 | $21K |
| 84703 | 1,980 | 1,696 | $20K | |
| 84460 | 5,002 | 3,699 | $19K | |
| 71045 | Radiologic examination, chest; single view | 33,910 | 27,771 | $19K |
| 85730 | 4,925 | 3,880 | $19K | |
| 84132 | 2,559 | 1,768 | $19K | |
| 76820 | 2,013 | 975 | $19K | |
| 97166 | 944 | 766 | $18K | |
| 87075 | 2,959 | 2,355 | $18K | |
| 87102 | 461 | 386 | $18K | |
| D2140 | 554 | 343 | $18K | |
| 73030 | 4,557 | 3,918 | $18K | |
| 84450 | 4,443 | 3,234 | $18K | |
| 93798 | 254 | 39 | $18K | |
| 72100 | 1,861 | 1,625 | $17K | |
| D1110 | Prophylaxis - adult | 634 | 588 | $17K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 800 | 657 | $16K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 624 | 436 | $16K |
| 83021 | 941 | 595 | $16K | |
| 87529 | 372 | 289 | $16K | |
| 36591 | 2,292 | 1,289 | $16K | |
| 82784 | 1,246 | 888 | $15K | |
| 80074 | 433 | 375 | $15K | |
| 82247 | 897 | 575 | $15K | |
| 86704 | 1,362 | 1,072 | $15K | |
| D0240 | 1,364 | 678 | $15K | |
| 82800 | 1,962 | 1,584 | $15K | |
| 94726 | 1,811 | 1,611 | $14K | |
| J2469 | Injection, palonosetron hcl, 25 mcg | 1,977 | 994 | $14K |
| Q3014 | Telehealth originating site facility fee | 2,428 | 2,032 | $14K |
| 11721 | 4,070 | 3,138 | $14K | |
| 97035 | 1,859 | 689 | $14K | |
| 84100 | 4,664 | 3,104 | $14K | |
| 83516 | 860 | 631 | $13K | |
| D0210 | Intraoral - complete series of radiographic images | 317 | 300 | $13K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 51 | 44 | $13K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 654 | 396 | $13K |
| 99000 | 4,219 | 3,471 | $13K | |
| 82010 | 2,082 | 1,682 | $12K | |
| 85046 | 2,797 | 1,685 | $12K | |
| 87205 | 4,036 | 3,136 | $12K | |
| 73610 | 4,254 | 3,746 | $12K | |
| 86235 | 226 | 152 | $12K | |
| 73502 | 2,726 | 2,354 | $12K | |
| 93296 | 428 | 379 | $12K | |
| 84481 | 1,040 | 787 | $12K | |
| 73564 | 5,087 | 4,429 | $12K | |
| 84403 | 571 | 486 | $11K | |
| 88307 | 1,070 | 829 | $11K | |
| 80164 | 764 | 589 | $11K | |
| 72141 | 209 | 187 | $11K | |
| 94660 | 146 | 67 | $11K | |
| D0272 | Bitewings - two radiographic images | 873 | 827 | $11K |
| 86003 | 173 | 144 | $11K | |
| 0240U | 318 | 282 | $10K | |
| 73130 | 3,973 | 3,517 | $10K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 425 | 360 | $10K |
| 36415 | Collection of venous blood by venipuncture | 129,343 | 91,767 | $10K |
| 72110 | 2,223 | 1,983 | $10K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 6,766 | 5,210 | $10K |
| D7140 | Extraction, erupted tooth or exposed root | 259 | 183 | $10K |
| 0042T | 196 | 151 | $10K | |
| 81511 | 96 | 63 | $10K | |
| 71271 | 186 | 171 | $9K | |
| 90670 | 1,118 | 820 | $9K | |
| 76937 | 968 | 725 | $9K | |
| 87631 | 86 | 77 | $9K | |
| 85018 | 4,229 | 3,082 | $9K | |
| 73110 | 2,165 | 1,934 | $9K | |
| 86038 | 873 | 697 | $9K | |
| 72040 | 580 | 534 | $9K | |
| 86923 | 606 | 413 | $9K | |
| J1756 | Injection, iron sucrose, 1 mg | 2,281 | 992 | $8K |
| 82248 | 2,053 | 1,678 | $8K | |
| 93308 | 80 | 67 | $8K | |
| 83001 | 520 | 421 | $8K | |
| 74183 | 107 | 89 | $8K | |
| 84160 | 749 | 544 | $8K | |
| 73562 | 898 | 749 | $8K | |
| 86787 | 1,165 | 905 | $8K | |
| 94644 | 629 | 503 | $8K | |
| 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 | 137 | 119 | $7K |
| 96368 | 109 | 78 | $7K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 130 | 115 | $7K |
| 84165 | 1,070 | 798 | $7K | |
| 96375 | Therapeutic injection; each additional sequential IV push | 30,759 | 22,473 | $7K |
| U0001 | Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel | 209 | 168 | $7K |
| 93458 | 12 | 12 | $7K | |
| 83721 | 1,225 | 990 | $7K | |
| D0140 | Limited oral evaluation - problem focused | 403 | 374 | $6K |
| 82378 | 768 | 455 | $6K | |
| 97165 | 568 | 397 | $6K | |
| 87206 | 796 | 672 | $6K | |
| 51702 | 381 | 314 | $6K | |
| 80329 | 1,874 | 1,495 | $6K | |
| 86039 | 617 | 489 | $6K | |
| 90686 | 2,801 | 2,019 | $6K | |
| 87088 | 622 | 463 | $6K | |
| 88342 | 3,266 | 2,459 | $5K | |
| 90723 | 724 | 575 | $5K | |
| 83020 | 700 | 571 | $5K | |
| 77334 | 212 | 124 | $5K | |
| 97535 | Self-care/home management training, each 15 minutes | 619 | 252 | $5K |
| 84146 | 357 | 278 | $5K | |
| 82803 | 316 | 263 | $5K | |
| 73140 | 1,507 | 1,361 | $5K | |
| 81015 | 752 | 643 | $5K | |
| 93922 | 165 | 147 | $5K | |
| 29125 | 205 | 178 | $5K | |
| 76870 | 172 | 154 | $5K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 92 | 82 | $5K |
| 90651 | 141 | 116 | $5K | |
| D0220 | Intraoral - periapical first radiographic image | 628 | 591 | $5K |
| 90680 | 413 | 316 | $4K | |
| 11056 | 331 | 220 | $4K | |
| 83520 | 346 | 264 | $4K | |
| 87045 | 159 | 126 | $4K | |
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 666 | 430 | $4K |
| 20610 | 183 | 96 | $4K | |
| 77080 | 166 | 145 | $4K | |
| 82947 | 1,186 | 945 | $4K | |
| 82105 | 199 | 171 | $4K | |
| 86431 | 494 | 430 | $4K | |
| 99222 | Initial hospital care, per day, moderate complexity | 91 | 72 | $4K |
| 92526 | 111 | 53 | $3K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 137 | 120 | $3K |
| H2012 | Behavioral health day treatment, per hour | 213 | 14 | $3K |
| 10061 | 45 | 41 | $3K | |
| 77061 | 300 | 281 | $3K | |
| H0022 | Alcohol and/or drug intervention service (planned facilitation) | 150 | 75 | $3K |
| 77412 | 160 | 12 | $3K | |
| 73560 | 279 | 225 | $3K | |
| 88304 | 1,562 | 1,285 | $3K | |
| 84520 | 1,080 | 881 | $3K | |
| 82652 | 173 | 146 | $3K | |
| 74022 | 714 | 593 | $3K | |
| 73080 | 1,141 | 1,018 | $3K | |
| 87505 | 28 | 26 | $3K | |
| 80177 | 203 | 172 | $3K | |
| 71101 | 1,421 | 1,267 | $3K | |
| 82805 | 101 | 81 | $3K | |
| J1453 | Injection, fosaprepitant, 1 mg | 445 | 215 | $3K |
| 43235 | 18 | 15 | $2K | |
| 87338 | 77 | 64 | $2K | |
| 73590 | 1,044 | 916 | $2K | |
| 86769 | 56 | 47 | $2K | |
| 99232 | Subsequent hospital care, per day, moderate complexity | 207 | 73 | $2K |
| G0176 | Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) | 242 | 37 | $2K |
| 90647 | 720 | 558 | $2K | |
| 87807 | 230 | 195 | $2K | |
| D4355 | 32 | 28 | $2K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 76 | 58 | $2K |
| 85049 | 518 | 352 | $2K | |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 205 | 162 | $2K |
| 98960 | 736 | 496 | $2K | |
| 86364 | 258 | 230 | $2K | |
| 96156 | 113 | 79 | $2K | |
| 96376 | 10,906 | 5,658 | $2K | |
| 97597 | 35 | 25 | $2K | |
| 43249 | 13 | 12 | $2K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 1,291 | 1,033 | $2K |
| 98962 | 314 | 36 | $2K | |
| 95806 | 49 | 40 | $2K | |
| 93246 | 110 | 91 | $2K | |
| D0230 | Intraoral - periapical each additional radiographic image | 342 | 309 | $2K |
| 82670 | 83 | 66 | $2K | |
| 82330 | 161 | 128 | $2K | |
| 87427 | 144 | 115 | $2K | |
| 82951 | 60 | 41 | $2K | |
| 86225 | 144 | 108 | $1K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 29 | 26 | $1K |
| 87328 | 43 | 39 | $1K | |
| 86430 | 301 | 234 | $1K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1,225 | 983 | $1K |
| 86255 | 48 | 39 | $1K | |
| 94002 | 22 | 13 | $1K | |
| 90832 | Psychotherapy, 30 minutes with patient | 97 | 48 | $1K |
| 90633 | 389 | 311 | $1K | |
| 77300 | 48 | 36 | $1K | |
| 82274 | 16 | 13 | $1K | |
| 76942 | 22 | 15 | $1K | |
| 73700 | 28 | 24 | $1K | |
| 74019 | 95 | 80 | $1K | |
| 90674 | 451 | 318 | $1K | |
| 72072 | 171 | 152 | $980.48 | |
| 86593 | 131 | 109 | $964.90 | |
| 82140 | 91 | 68 | $959.91 | |
| 82533 | 38 | 36 | $914.28 | |
| 73660 | 92 | 81 | $886.46 | |
| 80178 | 29 | 26 | $822.96 | |
| 0004A | 128 | 119 | $819.52 | |
| 17110 | 22 | 12 | $812.24 | |
| 95800 | 12 | 12 | $810.41 | |
| G0177 | Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more) | 190 | 25 | $807.49 |
| 87220 | 160 | 90 | $784.49 | |
| 87449 | 107 | 75 | $773.48 | |
| 74174 | 13 | 12 | $714.01 | |
| 93242 | 27 | 25 | $705.01 | |
| 99152 | 3,515 | 2,752 | $699.39 | |
| 83883 | 69 | 37 | $692.60 | |
| 88112 | 88 | 68 | $672.63 | |
| 82164 | 15 | 12 | $661.48 | |
| 94690 | 293 | 250 | $660.19 | |
| 86696 | 34 | 31 | $645.98 | |
| 93880 | 28 | 27 | $645.66 | |
| 90685 | 133 | 111 | $640.04 | |
| 97150 | Therapeutic procedure(s), group (2 or more individuals) | 112 | 45 | $635.68 |
| 36416 | 11,490 | 8,743 | $629.32 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 1,432 | 1,125 | $620.76 |
| D0330 | Panoramic radiographic image | 22 | 19 | $619.00 |
| 93325 | 30 | 26 | $606.87 | |
| 87563 | 30 | 26 | $578.82 | |
| 88341 | 695 | 489 | $574.69 | |
| 90710 | 201 | 167 | $548.26 | |
| 90734 | 53 | 41 | $532.03 | |
| 81002 | 387 | 274 | $529.50 | |
| A9270 | Non-covered item or service | 72,036 | 32,474 | $517.26 |
| 99406 | 288 | 211 | $517.10 | |
| 86200 | 61 | 53 | $483.73 | |
| 86308 | 99 | 91 | $482.36 | |
| 94375 | 32 | 26 | $474.08 | |
| 82977 | 15 | 15 | $462.38 | |
| 82150 | 110 | 82 | $452.37 | |
| 86694 | 20 | 12 | $425.89 | |
| 86695 | 33 | 30 | $421.72 | |
| 73090 | 389 | 353 | $419.56 | |
| 87280 | 41 | 39 | $407.07 | |
| 80320 | 4,498 | 3,799 | $394.68 | |
| 87046 | 159 | 126 | $381.51 | |
| 82040 | 41 | 26 | $374.52 | |
| J3475 | Injection, magnesium sulfate, per 500 mg | 5,159 | 2,649 | $371.70 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 240 | 220 | $344.47 |
| 90714 | 56 | 43 | $330.79 | |
| 83002 | 32 | 26 | $328.65 | |
| 86300 | 26 | 12 | $328.54 | |
| J7050 | Infusion, normal saline solution, 250 cc | 592 | 299 | $325.69 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 1,833 | 1,461 | $318.26 |
| 90656 | 139 | 91 | $295.01 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 28,021 | 21,804 | $291.05 |
| 93270 | 19 | 15 | $285.70 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 16,235 | 11,963 | $285.27 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 98 | 90 | $271.02 |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 1,275 | 1,021 | $270.72 |
| 80349 | 115 | 68 | $270.05 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 27,999 | 20,609 | $264.15 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 33 | 13 | $244.51 |
| 86334 | 20 | 17 | $237.50 | |
| 88184 | 42 | 25 | $225.37 | |
| 98926 | 110 | 91 | $223.65 | |
| G0008 | Administration of influenza virus vaccine | 2,544 | 1,842 | $223.29 |
| 86160 | 20 | 12 | $209.98 | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 22 | 12 | $207.09 |
| J0360 | Injection, hydralazine hcl, up to 20 mg | 1,660 | 1,143 | $207.02 |
| 90681 | 51 | 42 | $205.15 | |
| 84480 | 15 | 13 | $199.41 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 488 | 296 | $194.50 |
| 87329 | 27 | 25 | $193.85 | |
| 87107 | 20 | 14 | $186.03 | |
| 82785 | 14 | 12 | $170.78 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 12,391 | 9,345 | $169.19 |
| J0690 | Injection, cefazolin sodium, 500 mg | 7,071 | 5,123 | $166.92 |
| 94150 | 282 | 251 | $158.07 | |
| 76882 | 12 | 12 | $155.84 | |
| 90700 | 44 | 40 | $152.66 | |
| 83525 | 14 | 12 | $141.72 | |
| 88312 | 58 | 42 | $127.44 | |
| J2704 | Injection, propofol, 10 mg | 14,808 | 10,590 | $123.63 |
| 99153 | Mod sedat endo service >5yrs | 3,735 | 3,006 | $123.56 |
| 0001A | 29 | 24 | $114.48 | |
| 83010 | 15 | 12 | $106.34 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 10,503 | 7,195 | $106.23 |
| 90461 | 171 | 161 | $105.70 | |
| 85347 | 39 | 25 | $102.10 | |
| 99188 | 14 | 13 | $100.80 | |
| 98925 | 17 | 14 | $99.18 | |
| 73552 | 104 | 91 | $98.82 | |
| 72050 | 38 | 36 | $98.23 | |
| 69209 | 21 | 16 | $95.10 | |
| 72052 | 93 | 87 | $93.57 | |
| 93271 | 14 | 14 | $93.52 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 13,189 | 10,096 | $91.81 |
| 88185 | 42 | 25 | $89.13 | |
| 80175 | 14 | 13 | $87.23 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | 4,360 | 1,378 | $85.16 |
| Q0111 | Wet mounts, including preparations of vaginal, cervical or skin specimens | 36 | 31 | $85.12 |
| 85651 | 24 | 19 | $71.01 | |
| 93041 | 13 | 13 | $69.48 | |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 4,936 | 3,046 | $67.52 |
| C1894 | Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser | 2,203 | 1,625 | $64.64 |
| C1769 | Guide wire | 3,165 | 2,187 | $64.21 |
| 80361 | 26 | 16 | $63.01 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 203 | 106 | $59.00 |
| 84155 | 31 | 26 | $53.59 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 8,354 | 5,960 | $50.07 |
| J1644 | Injection, heparin sodium, per 1000 units | 4,541 | 1,995 | $42.13 |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 535 | 409 | $39.96 |
| 94762 | 89 | 63 | $39.66 | |
| 86580 | 15 | 12 | $32.08 | |
| 90474 | 18 | 16 | $26.36 | |
| 90473 | 68 | 59 | $26.36 | |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 7,982 | 3,106 | $25.94 |
| 90662 | 481 | 378 | $19.13 | |
| J3480 | Injection, potassium chloride, per 2 meq | 1,745 | 1,030 | $18.51 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 5,972 | 4,662 | $15.67 |
| 80365 | 26 | 16 | $14.94 | |
| J1815 | Injection, insulin, per 5 units | 6,335 | 2,118 | $13.88 |
| J2785 | Injection, regadenoson, 0.1 mg | 795 | 633 | $12.43 |
| J2060 | Injection, lorazepam, 2 mg | 3,543 | 2,718 | $11.92 |
| 82310 | 30 | 15 | $10.49 | |
| A4648 | Tissue marker, implantable, any type, each | 524 | 427 | $10.24 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 2,063 | 1,519 | $9.93 |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | 204 | 150 | $9.27 |
| 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) | 1,066 | 942 | $8.83 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 160 | 144 | $8.82 |
| 90732 | 42 | 28 | $8.39 | |
| J1170 | Injection, hydromorphone, up to 4 mg | 7,970 | 4,569 | $8.17 |
| J3370 | Injection, vancomycin hcl, 500 mg | 378 | 195 | $4.33 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 8,403 | 5,848 | $3.94 |
| 94760 | 452 | 393 | $2.76 | |
| J7060 | 5% dextrose/water (500 ml = 1 unit) | 1,043 | 535 | $1.47 |
| J2370 | Injection, phenylephrine hcl, up to 1 ml | 1,152 | 829 | $1.07 |
| J0171 | Injection, adrenalin, epinephrine, 0.1 mg | 690 | 494 | $0.92 |
| J3360 | Injection, diazepam, up to 5 mg | 329 | 243 | $0.80 |
| J1630 | Injection, haloperidol, up to 5 mg | 621 | 467 | $0.31 |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | 3,676 | 3,177 | $0.19 |
| J0500 | Injection, dicyclomine hcl, up to 20 mg | 278 | 232 | $0.18 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 2,080 | 1,646 | $0.04 |
| C1887 | Catheter, guiding (may include infusion/perfusion capability) | 528 | 359 | $0.03 |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 560 | 440 | $0.00 |
| J1790 | Injection, droperidol, up to 5 mg | 1,688 | 1,360 | $0.00 |
| J3490 | Unclassified drugs | 1,105 | 878 | $0.00 |
| 72170 | 60 | 52 | $0.00 | |
| G8988 | Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting | 252 | 179 | $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 | 200 | 177 | $0.00 |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 15 | 13 | $0.00 |
| J1940 | Injection, furosemide, up to 20 mg | 1,388 | 699 | $0.00 |
| C9399 | Unclassified drugs or biologicals | 333 | 232 | $0.00 |
| J8540 | Dexamethasone, oral, 0.25 mg | 506 | 433 | $0.00 |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 238 | 151 | $0.00 |
| D0603 | 32 | 32 | $0.00 | |
| D0120 | Periodic oral evaluation - established patient | 15 | 15 | $0.00 |
| G0009 | Administration of pneumococcal vaccine | 369 | 201 | $0.00 |
| 76377 | 261 | 225 | $0.00 | |
| G8980 | Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting | 74 | 58 | $0.00 |
| J1805 | Injection, esmolol hydrochloride, 10 mg | 30 | 26 | $0.00 |
| J2470 | Injection, pantoprazole sodium, 40 mg | 26 | 19 | $0.00 |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 139 | 52 | $0.00 |
| J1920 | Injection, labetalol hydrochloride, 5 mg | 229 | 164 | $0.00 |
| 94761 | 15 | 14 | $0.00 | |
| J1726 | Injection, hydroxyprogesterone caproate, (makena), 10 mg | 208 | 50 | $0.00 |
| G8987 | Self care functional limitation, current status, at therapy episode outset and at reporting intervals | 251 | 177 | $0.00 |
| 51798 | 45 | 40 | $0.00 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 88 | 74 | $0.00 |
| 99495 | 38 | 25 | $0.00 | |
| 99459 | 13 | 12 | $0.00 | |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 30 | 12 | $0.00 |
| C1781 | Mesh (implantable) | 42 | 37 | $0.00 |
| 82435 | 27 | 12 | $0.00 | |
| J9045 | Injection, carboplatin, 50 mg | 19 | 12 | $0.00 |
| 91307 | 13 | 13 | $0.00 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 54 | 26 | $0.00 |
| Q9968 | Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg | 13 | 12 | $0.00 |
| J7611 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg | 19 | 17 | $0.00 |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 15 | 12 | $0.00 |
| 73060 | 15 | 12 | $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 | 562 | 421 | $0.00 |
| S0164 | Injection, pantoprazole sodium, 40 mg | 1,565 | 975 | $0.00 |
| 93319 | 83 | 79 | $0.00 | |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 268 | 197 | $0.00 |
| S0028 | Injection, famotidine, 20 mg | 1,578 | 1,256 | $0.00 |
| J3489 | Injection, zoledronic acid, 1 mg | 34 | 27 | $0.00 |
| 83037 | 99 | 92 | $0.00 | |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | 514 | 389 | $0.00 |
| 91312 | 13 | 13 | $0.00 | |
| G8990 | Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals | 127 | 115 | $0.00 |
| A4358 | Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each | 118 | 92 | $0.00 |
| C1760 | Closure device, vascular (implantable/insertable) | 294 | 221 | $0.00 |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 630 | 540 | $0.00 |
| J1953 | Injection, levetiracetam, 10 mg | 168 | 130 | $0.00 |
| 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 | 14 | 12 | $0.00 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 89 | 80 | $0.00 |
| 69210 | 23 | 14 | $0.00 | |
| C1729 | Catheter, drainage | 15 | 12 | $0.00 |
| 84295 | 27 | 12 | $0.00 | |
| A6212 | Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing | 34 | 26 | $0.00 |
| J1596 | Injection, glycopyrrolate, 0.1 mg | 295 | 234 | $0.00 |
| 82374 | 27 | 12 | $0.00 | |
| C9113 | Injection, pantoprazole sodium, per vial | 14 | 13 | $0.00 |
| J1171 | Injection, hydromorphone, 0.1 mg | 183 | 107 | $0.00 |
| 0124A | 15 | 15 | $0.00 | |
| J2310 | Injection, naloxone hydrochloride, per 1 mg | 14 | 12 | $0.00 |
| 88173 | 35 | 24 | $0.00 | |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 37 | 12 | $0.00 |