NPI: 1902832306 · APPLETON, WI 54911 · General Acute Care Hospital · NPI assigned 06/25/2006
Authorized official FLETT, WILLIAM controls 20+ related entities in our dataset. Read more
| Authorized Official | FLETT, WILLIAM (CFO) |
| NPI Enumeration Date | 06/25/2006 |
Other providers sharing the same authorized official: FLETT, WILLIAM
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 71,240 | $1.48M |
| 2019 | 76,158 | $1.45M |
| 2020 | 79,830 | $1.42M |
| 2021 | 106,107 | $1.55M |
| 2022 | 100,457 | $1.55M |
| 2023 | 116,028 | $2.01M |
| 2024 | 94,501 | $2.07M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 21,827 | 18,914 | $1.18M |
| 99284 | Emergency department visit for the evaluation and management, high severity | 21,892 | 18,285 | $991K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 10,449 | 9,380 | $689K |
| 96361 | Intravenous infusion, hydration; each additional hour | 5,723 | 4,560 | $685K |
| 80048 | Basic metabolic panel (calcium, ionized) | 35,816 | 27,449 | $637K |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 16,385 | 15,057 | $414K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 10,139 | 9,205 | $395K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 5,014 | 3,794 | $333K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 4,411 | 3,984 | $324K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 8,717 | 8,150 | $292K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 10,137 | 9,203 | $287K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 6,050 | 5,331 | $281K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 3,644 | 3,270 | $235K |
| 70450 | Computed tomography, head or brain; without contrast material | 3,768 | 3,322 | $220K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 1,105 | 1,038 | $220K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 33,833 | 27,225 | $207K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2,122 | 1,966 | $206K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 11,218 | 8,760 | $192K |
| 41899 | Unlisted procedure, dentoalveolar structures | 678 | 536 | $190K |
| 87631 | 1,549 | 1,345 | $155K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 5,450 | 2,579 | $141K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 6,045 | 2,886 | $140K |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 3,217 | 2,854 | $137K |
| 71275 | Computed tomographic angiography, chest, with contrast material | 1,751 | 1,562 | $122K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 2,988 | 2,291 | $114K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 1,680 | 1,257 | $113K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 407 | 383 | $91K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 1,226 | 680 | $91K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 1,290 | 1,181 | $86K |
| 80076 | 11,398 | 9,549 | $78K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 5,643 | 5,042 | $73K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 1,744 | 791 | $73K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 522 | 491 | $71K |
| 84443 | Thyroid stimulating hormone (TSH) | 5,032 | 4,499 | $62K |
| 84484 | 8,547 | 5,271 | $61K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 1,484 | 1,324 | $61K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 3,184 | 1,493 | $59K |
| G0378 | Hospital observation service, per hour | 4,907 | 2,186 | $56K |
| 85610 | 6,407 | 4,703 | $55K | |
| 81025 | 5,932 | 5,237 | $55K | |
| 93017 | 1,190 | 1,117 | $48K | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1,707 | 1,490 | $48K |
| 58571 | 28 | 25 | $44K | |
| 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 | 992 | 846 | $44K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 959 | 878 | $42K |
| 82948 | 5,778 | 2,574 | $41K | |
| 81001 | 10,713 | 9,302 | $37K | |
| 83690 | 6,656 | 5,676 | $34K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1,529 | 697 | $34K |
| 86850 | 2,319 | 2,045 | $32K | |
| 97162 | 933 | 848 | $32K | |
| 80306 | 2,159 | 1,869 | $31K | |
| 87070 | 1,685 | 1,392 | $30K | |
| 83880 | 1,791 | 1,570 | $30K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 734 | 577 | $27K |
| 88307 | 961 | 837 | $26K | |
| 93971 | 799 | 731 | $26K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 92 | 89 | $26K |
| 85027 | 3,780 | 3,103 | $26K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 466 | 401 | $25K |
| 85380 | 3,320 | 2,962 | $25K | |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | 49 | 44 | $24K |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | 40 | 39 | $24K |
| 84702 | 1,437 | 1,007 | $24K | |
| 83036 | Hemoglobin; glycosylated (A1C) | 1,226 | 1,090 | $24K |
| 72125 | Computed tomography, cervical spine; without contrast material | 1,246 | 1,109 | $23K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 994 | 903 | $21K |
| 82947 | 4,016 | 2,534 | $21K | |
| 99215 | Prolong outpt/office vis | 304 | 246 | $20K |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | 2,856 | 2,514 | $19K |
| 87650 | 334 | 324 | $19K | |
| 95886 | 253 | 239 | $19K | |
| 83605 | 2,969 | 2,360 | $19K | |
| 71046 | Radiologic examination, chest; 2 views | 4,787 | 4,218 | $19K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 1,896 | 838 | $19K |
| 86900 | 2,347 | 2,041 | $17K | |
| 97163 | 725 | 659 | $17K | |
| 82565 | 2,029 | 1,663 | $17K | |
| 88342 | 2,000 | 1,668 | $16K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 236 | 204 | $16K |
| 84439 | 1,133 | 1,002 | $16K | |
| 81003 | 3,906 | 3,475 | $16K | |
| 12001 | 136 | 127 | $15K | |
| 88304 | 1,115 | 1,011 | $14K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 300 | 268 | $14K |
| 83735 | 3,308 | 2,390 | $13K | |
| 80061 | Lipid panel | 854 | 767 | $13K |
| 93922 | 500 | 478 | $13K | |
| 82077 | 1,313 | 1,112 | $12K | |
| 87510 | 812 | 753 | $12K | |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 418 | 330 | $11K |
| G0330 | Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room | 231 | 194 | $11K |
| 94060 | 336 | 302 | $11K | |
| 86140 | 2,099 | 1,688 | $11K | |
| 80053 | Comprehensive metabolic panel | 706 | 587 | $11K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 191 | 171 | $11K |
| 85651 | 965 | 796 | $11K | |
| 93226 | 516 | 474 | $11K | |
| 87480 | 631 | 582 | $11K | |
| 93225 | 480 | 440 | $10K | |
| 87186 | 1,960 | 1,759 | $10K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 5,634 | 3,691 | $10K |
| 87040 | 1,788 | 887 | $10K | |
| 82962 | 2,071 | 921 | $9K | |
| 97161 | 202 | 189 | $9K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 17,462 | 14,450 | $8K |
| 87088 | 1,736 | 1,574 | $8K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 500 | 457 | $8K |
| 87340 | 973 | 882 | $8K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 13,257 | 10,793 | $8K |
| 82330 | 530 | 410 | $8K | |
| 93458 | 14 | 13 | $7K | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 108 | 105 | $7K |
| 86780 | 710 | 640 | $6K | |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 16 | 13 | $6K |
| 86803 | 524 | 487 | $6K | |
| 82805 | 286 | 238 | $6K | |
| 80143 | 539 | 477 | $6K | |
| 88341 | 691 | 533 | $6K | |
| 97803 | 364 | 210 | $6K | |
| 76830 | Ultrasound, transvaginal | 170 | 151 | $6K |
| 74018 | 1,077 | 945 | $5K | |
| 87150 | 169 | 154 | $5K | |
| 86901 | 2,348 | 2,041 | $5K | |
| 82950 | 630 | 591 | $5K | |
| 71045 | Radiologic examination, chest; single view | 7,510 | 6,418 | $5K |
| 87081 | 879 | 796 | $5K | |
| 87507 | 18 | 12 | $5K | |
| 80179 | 459 | 410 | $5K | |
| 87210 | 576 | 514 | $4K | |
| 85730 | 947 | 755 | $4K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 14 | 13 | $4K |
| 85379 | 357 | 333 | $4K | |
| 94729 | 484 | 438 | $4K | |
| 93325 | 201 | 171 | $4K | |
| 93308 | 27 | 25 | $4K | |
| 87653 | 88 | 85 | $4K | |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 12 | 12 | $3K |
| 12011 | 42 | 38 | $3K | |
| 84132 | 658 | 525 | $3K | |
| 88360 | 105 | 84 | $3K | |
| 84703 | 436 | 401 | $3K | |
| 87807 | 182 | 160 | $3K | |
| 94726 | 260 | 235 | $3K | |
| 96375 | Therapeutic injection; each additional sequential IV push | 13,108 | 10,357 | $3K |
| 86703 | 153 | 144 | $3K | |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 33 | 31 | $3K |
| 88112 | 180 | 152 | $2K | |
| 86762 | 182 | 169 | $2K | |
| 70498 | 26 | 25 | $2K | |
| 97802 | 159 | 140 | $2K | |
| 85014 | 1,198 | 918 | $2K | |
| 43248 | 12 | 12 | $2K | |
| 82803 | 227 | 190 | $2K | |
| 85652 | 732 | 630 | $2K | |
| 90715 | 346 | 304 | $2K | |
| 97166 | 140 | 127 | $2K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 13 | 12 | $2K |
| 93970 | 53 | 49 | $2K | |
| 93321 | 14 | 12 | $2K | |
| 36415 | Collection of venous blood by venipuncture | 15,713 | 11,739 | $2K |
| 72100 | 278 | 258 | $2K | |
| 76937 | 512 | 455 | $1K | |
| 96367 | 29 | 28 | $1K | |
| 29125 | 29 | 25 | $1K | |
| 84460 | 352 | 253 | $1K | |
| 70496 | 13 | 13 | $1K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 65 | 58 | $1K |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 26 | 25 | $1K |
| 87660 | 88 | 75 | $1K | |
| 84295 | 317 | 254 | $1K | |
| 73140 | 14 | 14 | $1K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 14,177 | 11,261 | $1K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 31 | 26 | $1K |
| 73630 | 618 | 561 | $1K | |
| 73610 | 582 | 523 | $948.73 | |
| 87486 | 16 | 13 | $854.77 | |
| 36592 | 829 | 530 | $780.56 | |
| 84145 | 66 | 55 | $776.97 | |
| 96376 | 4,200 | 3,060 | $776.09 | |
| 99152 | 2,667 | 2,371 | $760.98 | |
| 74019 | 413 | 368 | $691.56 | |
| 97535 | Self-care/home management training, each 15 minutes | 282 | 144 | $667.55 |
| 88738 | 29 | 25 | $604.36 | |
| 76536 | 15 | 12 | $588.68 | |
| 73564 | 420 | 379 | $585.02 | |
| 73030 | 262 | 230 | $558.30 | |
| 77001 | 17 | 15 | $539.04 | |
| 87581 | 16 | 13 | $516.77 | |
| 82550 | 103 | 86 | $415.83 | |
| 82435 | 222 | 190 | $407.92 | |
| 87625 | 14 | 14 | $401.18 | |
| 86787 | 58 | 51 | $366.29 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 438 | 373 | $323.46 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 8,880 | 7,792 | $321.22 |
| 85018 | 215 | 167 | $308.30 | |
| 85049 | 14 | 12 | $304.46 | |
| 82570 | 79 | 65 | $293.98 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 7,930 | 6,524 | $281.81 |
| 84481 | 29 | 25 | $281.73 | |
| 84100 | 87 | 58 | $277.52 | |
| J2704 | Injection, propofol, 10 mg | 10,155 | 8,595 | $275.99 |
| J0690 | Injection, cefazolin sodium, 500 mg | 3,789 | 2,836 | $239.66 |
| 87205 | 107 | 77 | $221.15 | |
| 80055 | 37 | 13 | $209.33 | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 272 | 248 | $206.78 |
| 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 | 189 | 170 | $200.00 |
| C1769 | Guide wire | 2,936 | 2,601 | $195.07 |
| 82728 | 26 | 26 | $186.68 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 14,465 | 11,038 | $185.91 |
| 84450 | 58 | 49 | $184.52 | |
| 93926 | 14 | 13 | $182.03 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 2,347 | 1,984 | $178.44 |
| 82140 | 14 | 13 | $124.80 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 13,207 | 10,670 | $124.35 |
| 73130 | 109 | 99 | $95.90 | |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 41 | 26 | $88.85 |
| J2785 | Injection, regadenoson, 0.1 mg | 278 | 262 | $87.01 |
| 88312 | 14 | 14 | $84.09 | |
| 99153 | Mod sedat endo service >5yrs | 1,553 | 1,394 | $80.27 |
| J7120 | Ringers lactate infusion, up to 1000 cc | 4,419 | 3,728 | $69.78 |
| 87075 | 15 | 15 | $69.47 | |
| 87147 | 15 | 14 | $48.22 | |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 527 | 492 | $46.99 |
| J2060 | Injection, lorazepam, 2 mg | 2,271 | 1,847 | $45.30 |
| 87077 | 16 | 15 | $43.20 | |
| C1725 | Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) | 90 | 80 | $40.10 |
| 76801 | 18 | 14 | $34.21 | |
| 84156 | 14 | 12 | $29.08 | |
| C1894 | Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser | 1,753 | 1,561 | $27.69 |
| 73502 | 67 | 53 | $22.85 | |
| Q9969 | Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose | 1,154 | 1,096 | $20.33 |
| 73560 | 12 | 12 | $19.80 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 3,406 | 2,805 | $19.75 |
| A9577 | Injection, gadobenate dimeglumine (multihance), per ml | 744 | 683 | $17.80 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 2,156 | 1,516 | $17.36 |
| J1644 | Injection, heparin sodium, per 1000 units | 2,739 | 1,757 | $17.27 |
| C1776 | Joint device (implantable) | 58 | 53 | $16.74 |
| C1760 | Closure device, vascular (implantable/insertable) | 40 | 39 | $16.67 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 6,436 | 5,557 | $14.37 |
| J7050 | Infusion, normal saline solution, 250 cc | 7,397 | 4,515 | $14.21 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 923 | 782 | $13.06 |
| J3475 | Injection, magnesium sulfate, per 500 mg | 674 | 425 | $11.77 |
| J1170 | Injection, hydromorphone, up to 4 mg | 3,854 | 2,759 | $11.63 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 3,115 | 2,379 | $10.71 |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 348 | 304 | $10.53 |
| J2370 | Injection, phenylephrine hcl, up to 1 ml | 828 | 722 | $9.69 |
| 72170 | 15 | 12 | $9.40 | |
| P9612 | Catheterization for collection of specimen, single patient, all places of service | 201 | 188 | $8.34 |
| J3490 | Unclassified drugs | 2,200 | 1,859 | $7.97 |
| J1790 | Injection, droperidol, up to 5 mg | 731 | 611 | $6.13 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 3,355 | 2,895 | $3.73 |
| J1650 | Injection, enoxaparin sodium, 10 mg | 1,037 | 379 | $3.31 |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 416 | 362 | $2.36 |
| C1887 | Catheter, guiding (may include infusion/perfusion capability) | 42 | 38 | $1.54 |
| J0360 | Injection, hydralazine hcl, up to 20 mg | 16 | 14 | $1.45 |
| J3360 | Injection, diazepam, up to 5 mg | 117 | 94 | $1.06 |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | 276 | 113 | $0.58 |
| J0171 | Injection, adrenalin, epinephrine, 0.1 mg | 243 | 103 | $0.44 |
| J1596 | Injection, glycopyrrolate, 0.1 mg | 96 | 87 | $0.42 |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 43 | 38 | $0.20 |
| A9270 | Non-covered item or service | 1,815 | 1,216 | $0.01 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 385 | 317 | $0.00 |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | 57 | 53 | $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 | 84 | 69 | $0.00 |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 718 | 603 | $0.00 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 25 | 23 | $0.00 |
| J7030 | Infusion, normal saline solution , 1000 cc | 127 | 93 | $0.00 |
| G1010 | Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program | 2,206 | 1,857 | $0.00 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | 15 | 14 | $0.00 |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 191 | 153 | $0.00 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 61 | 45 | $0.00 |
| 73110 | 51 | 49 | $0.00 | |
| J2550 | Injection, promethazine hcl, up to 50 mg | 102 | 85 | $0.00 |
| J0134 | Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg | 30 | 24 | $0.00 |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | 56 | 40 | $0.00 |
| J3370 | Injection, vancomycin hcl, 500 mg | 86 | 59 | $0.00 |
| C1758 | Catheter, ureteral | 35 | 26 | $0.00 |
| J1171 | Injection, hydromorphone, 0.1 mg | 35 | 30 | $0.00 |
| C1726 | Catheter, balloon dilatation, non-vascular | 143 | 134 | $0.00 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 510 | 476 | $0.00 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 379 | 285 | $0.00 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 19 | 12 | $0.00 |
| J1630 | Injection, haloperidol, up to 5 mg | 25 | 24 | $0.00 |
| J2002 | Injection, lidocaine hcl in 5% dextrose, 1 mg | 55 | 54 | $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 | 148 | 93 | $0.00 |
| J0697 | Injection, sterile cefuroxime sodium, per 750 mg | 67 | 64 | $0.00 |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 21 | 13 | $0.00 |
| C2617 | Stent, non-coronary, temporary, without delivery system | 18 | 13 | $0.00 |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 18 | 13 | $0.00 |