Medicaid Provider Spending

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

DALLAS COUNTY HOSPITAL DISTRICT

NPI: 1932123247 · DALLAS, TX 75235 · Ambulatory Surgical Clinic/Center · NPI assigned 07/27/2006

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

Authorized official CERISE, FREDERICK controls 20+ related entities in our dataset. Read more

$152.60M
Total Medicaid Paid
3,288,824
Total Claims
2,866,067
Beneficiaries
610
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialCERISE, FREDERICK (PRESIDENT/CHIEF EXECUTIVE OFFICER)
Parent OrganizationDALLAS COUNTY HOSPITAL DISTRICT
NPI Enumeration Date07/27/2006

Related Entities

Other providers sharing the same authorized official: CERISE, FREDERICK

ProviderCityStateTotal Paid
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $9.03M
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $4.00M
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $3.66M
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $3.32M
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $3.14M
DALLAS COUNTY HOSPITAL DISTRICT GARLAND TX $3.03M
DALLAS COUNTY HOSPITAL DISTRICT IRVING TX $1.52M
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $1.51M
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $1.11M
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $962K
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $901K
DALLAS COUNTY HOSPITAL DISTRICT GARLAND TX $851K
DALLAS COUNTY HOSPITAL DISTRICT GRAND PRAIRIE TX $785K
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $729K
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $705K
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $571K
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $515K
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $483K
DALLAS COUNTY HOSPITAL DISTRICT DALLAS TX $455K
DALLAS COUNTY HOSPITAL DISTRICT GARLAND TX $446K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,854 $18K
2019 17,111 $611K
2020 216,258 $7.79M
2021 888,880 $38.03M
2022 860,511 $40.44M
2023 763,611 $38.64M
2024 540,599 $27.07M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 202,096 177,785 $21.73M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 205,236 173,075 $14.92M
J9271 Injection, pembrolizumab, 1 mg 853 703 $11.66M
99284 Emergency department visit for the evaluation and management, high severity 35,558 31,864 $11.55M
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 97,090 88,958 $7.28M
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 33,404 32,654 $4.85M
81420 Fetal chromosomal aneuploidy genomic sequence analysis panel 7,579 6,793 $4.39M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 15,332 13,998 $4.11M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 30,475 27,837 $3.32M
86850 56,985 50,076 $2.66M
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 94,967 87,472 $2.60M
74177 Computed tomography, abdomen and pelvis; with contrast material 6,141 5,864 $1.97M
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 28,380 23,199 $1.91M
99283 Emergency department visit for the evaluation and management, moderate severity 33,380 29,469 $1.80M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 12,706 11,408 $1.64M
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 57,068 54,422 $1.52M
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 29,222 26,529 $1.48M
86780 92,067 84,079 $1.44M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 3,754 3,676 $1.44M
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 12,036 10,799 $1.18M
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 15,551 14,501 $1.14M
J9035 Injection, bevacizumab, 10 mg 278 129 $996K
87084 42,125 36,792 $950K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 6,007 4,103 $922K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 6,643 6,032 $796K
96361 Intravenous infusion, hydration; each additional hour 7,377 5,738 $783K
90715 23,124 22,547 $769K
80053 Comprehensive metabolic panel 63,172 51,077 $764K
84702 32,286 27,759 $750K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 9,264 4,719 $744K
J9312 Injection, rituximab, 10 mg 132 105 $718K
J2505 Injection, pegfilgrastim, 6 mg 114 82 $694K
J0585 Injection, onabotulinumtoxina, 1 unit 427 324 $683K
86762 42,187 37,005 $663K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 51,595 41,265 $649K
87340 52,376 46,533 $632K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 23,265 21,830 $627K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 6,536 6,003 $616K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 1,325 1,306 $606K
87536 5,891 5,734 $596K
70450 Computed tomography, head or brain; without contrast material 4,919 4,617 $567K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 70,605 57,348 $565K
90677 1,470 1,440 $561K
81003 126,545 106,312 $530K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 2,788 2,695 $526K
71260 Computed tomography, thorax, diagnostic; with contrast material 2,588 2,553 $521K
77067 Screening mammography, bilateral, including computer-aided detection 4,813 4,783 $507K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 3,956 2,822 $466K
71275 Computed tomographic angiography, chest, with contrast material 1,897 1,802 $452K
74183 950 938 $428K
J9144 Injection, daratumumab, 10 mg and hyaluronidase-fihj 73 40 $425K
84703 43,049 38,209 $424K
99281 Emergency department visit for the evaluation and management, self-limited or minor 10,632 7,797 $416K
99215 Prolong outpt/office vis 4,114 3,659 $415K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 4,991 4,649 $414K
90688 23,589 22,618 $403K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 6,218 5,782 $398K
88305 Level IV - Surgical pathology, gross and microscopic examination 4,495 4,285 $385K
81025 27,338 23,624 $384K
83880 10,456 9,410 $364K
80061 Lipid panel 21,090 20,555 $362K
99205 Prolong outpt/office vis 3,730 3,242 $352K
J0185 Injection, aprepitant, 1 mg 902 615 $347K
86900 59,323 52,043 $343K
84443 Thyroid stimulating hormone (TSH) 20,939 19,785 $341K
83036 Hemoglobin; glycosylated (A1C) 32,938 31,839 $338K
82677 12,230 11,569 $335K
82105 14,175 13,378 $333K
76801 2,939 2,876 $331K
86901 59,324 52,042 $327K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 3,485 3,289 $326K
0002A 10,009 9,914 $319K
74176 Computed tomography, abdomen and pelvis; without contrast material 1,606 1,532 $318K
71046 Radiologic examination, chest; 2 views 8,641 8,089 $312K
76705 Ultrasound, abdominal, real time with image documentation; limited 3,221 3,086 $312K
82565 49,646 44,537 $308K
J1745 Injection, infliximab, excludes biosimilar, 10 mg 42 36 $295K
85049 39,428 34,445 $294K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 9,437 9,160 $293K
85013 37,119 34,857 $289K
86336 12,320 11,654 $268K
80048 Basic metabolic panel (calcium, ionized) 34,397 26,134 $267K
77063 Screening digital breast tomosynthesis, bilateral 4,242 4,212 $263K
82950 30,585 29,696 $259K
85027 36,806 28,718 $257K
84484 19,466 10,550 $256K
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 12,083 11,251 $255K
82947 42,473 37,512 $244K
0001A 10,988 10,706 $242K
71045 Radiologic examination, chest; single view 9,883 8,771 $237K
99282 Emergency department visit for the evaluation and management, low to moderate severity 5,198 4,371 $234K
87086 Culture, bacterial; quantitative colony count, urine 23,254 21,638 $234K
71250 2,050 2,012 $229K
20610 1,394 1,293 $226K
93970 1,077 1,035 $225K
85014 50,494 44,907 $212K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 1,547 1,467 $205K
86923 1,153 942 $204K
87428 3,692 3,553 $199K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,049 766 $198K
45380 Colonoscopy, flexible; with biopsy, single or multiple 442 425 $198K
96375 Therapeutic injection; each additional sequential IV push 10,432 7,867 $188K
Q5107 Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg 65 26 $182K
93971 1,437 1,361 $181K
78815 Positron emission tomography (PET) for limited area imaging 110 110 $180K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 10,956 9,165 $175K
86361 5,523 5,384 $175K
86481 1,868 1,809 $170K
P9016 Red blood cells, leukocytes reduced, each unit 1,033 829 $170K
J2506 Injection, pegfilgrastim, excludes biosimilar, 0.5 mg 39 28 $169K
96416 921 569 $168K
76830 Ultrasound, transvaginal 1,038 1,017 $164K
96367 2,237 1,849 $163K
76770 1,304 1,257 $157K
85018 18,142 16,920 $155K
83655 14,683 14,350 $153K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 4,157 4,009 $152K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 7,304 6,641 $149K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 565 553 $144K
72125 Computed tomography, cervical spine; without contrast material 1,234 1,184 $142K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 455 441 $141K
86803 13,121 12,093 $140K
83970 3,879 3,765 $137K
96417 1,698 1,216 $134K
83735 22,621 15,117 $132K
70551 Magnetic resonance imaging, brain; without contrast material 515 496 $132K
80050 General health panel 747 711 $126K
82728 7,629 7,347 $117K
16020 925 789 $116K
76642 1,275 1,200 $114K
73630 2,966 2,706 $114K
96415 1,969 1,471 $111K
J0561 Injection, penicillin g benzathine, 100,000 units 241 167 $103K
31575 960 919 $103K
90670 1,618 1,523 $99K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 2,592 2,200 $99K
73560 2,541 2,335 $95K
94060 508 502 $94K
94729 1,032 1,017 $93K
93308 756 725 $92K
91320 1,040 927 $92K
49083 182 122 $91K
97162 1,572 1,469 $91K
76857 1,222 1,184 $91K
76825 303 274 $89K
93017 341 338 $88K
87210 13,505 12,552 $88K
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants 178 167 $87K
84460 15,511 14,881 $87K
84450 16,441 15,622 $87K
97161 2,062 1,893 $85K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 11,893 8,618 $80K
87522 Neg quan hep c or qual rna 1,609 1,537 $80K
82951 4,236 4,172 $79K
95811 119 118 $77K
90732 1,136 1,099 $77K
73030 2,087 1,964 $77K
92134 2,506 2,433 $74K
90472 Immunization administration, each additional vaccine (list separately) 5,444 3,853 $74K
73502 1,476 1,395 $72K
92083 1,590 1,558 $72K
83690 11,204 10,148 $70K
81001 22,898 20,664 $70K
72131 582 562 $69K
73610 1,740 1,613 $67K
97530 Therapeutic activities, direct patient contact, each 15 minutes 1,623 1,087 $67K
76536 566 557 $66K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 1,024 1,016 $65K
96376 3,949 2,607 $65K
97165 987 957 $64K
77066 Tomosynthesis, mammo 448 447 $64K
J0881 Injection, darbepoetin alfa, 1 microgram (non-esrd use) 121 89 $64K
84439 6,190 5,880 $63K
92557 822 808 $62K
86870 553 516 $62K
85610 15,847 12,127 $61K
72100 1,343 1,318 $61K
87040 5,595 2,961 $60K
90678 299 286 $59K
51702 671 611 $59K
84100 17,028 12,385 $59K
82274 3,609 3,547 $58K
73130 1,381 1,237 $58K
83605 5,644 4,190 $56K
J0640 Injection, leucovorin calcium, per 50 mg 568 237 $55K
93923 336 332 $55K
88720 11,200 10,649 $55K
97166 631 612 $53K
82803 2,302 1,904 $53K
94010 547 532 $52K
85660 6,589 5,804 $51K
J0696 Injection, ceftriaxone sodium, per 250 mg 4,216 3,060 $51K
94726 656 644 $51K
67028 Intravitreal injection of a pharmacologic agent 986 959 $51K
70496 253 242 $50K
82607 3,975 3,862 $50K
70498 254 242 $49K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 595 538 $49K
G0257 Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility 368 181 $48K
J3370 Injection, vancomycin hcl, 500 mg 1,541 869 $48K
87902 161 158 $47K
P9047 Infusion, albumin (human), 25%, 50 ml 210 134 $47K
70491 232 225 $47K
73110 1,019 915 $47K
82247 10,464 8,603 $46K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 637 593 $46K
82570 8,738 7,964 $45K
J1050 Injection, medroxyprogesterone acetate, 1 mg 762 740 $45K
88342 703 661 $44K
72158 111 107 $42K
90656 2,328 2,278 $42K
90832 Psychotherapy, 30 minutes with patient 1,006 776 $42K
59025 Fetal non-stress test 832 801 $42K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 67 67 $41K
92227 1,709 1,672 $39K
73590 1,125 1,048 $37K
83550 4,704 4,574 $37K
87186 4,545 4,282 $36K
58100 177 170 $36K
84156 8,949 7,663 $36K
92133 1,248 1,236 $36K
51798 642 634 $36K
J2469 Injection, palonosetron hcl, 25 mcg 413 263 $35K
85379 1,668 1,574 $35K
86140 6,852 6,339 $35K
86704 2,678 2,571 $34K
88341 232 213 $34K
93922 230 227 $34K
80051 5,203 4,999 $33K
J9190 Injection, fluorouracil, 500 mg 1,331 578 $33K
90756 1,773 1,714 $33K
J1644 Injection, heparin sodium, per 1000 units 5,692 2,646 $33K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 97 96 $32K
72141 125 125 $32K
78306 115 115 $31K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 603 583 $31K
85007 8,377 6,541 $31K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 6,127 5,859 $31K
88142 1,581 1,488 $30K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 710 426 $30K
71271 179 178 $30K
J1453 Injection, fosaprepitant, 1 mg 354 237 $30K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 6,691 4,935 $30K
96401 460 253 $29K
J9263 Injection, oxaliplatin, 0.5 mg 238 110 $28K
73552 742 693 $28K
97116 871 619 $28K
86706 2,303 2,241 $27K
J1650 Injection, enoxaparin sodium, 10 mg 4,687 2,588 $27K
82378 1,329 1,060 $27K
87077 3,745 3,512 $27K
84153 1,825 1,707 $27K
82040 5,611 5,388 $27K
84403 1,132 1,058 $26K
74174 67 67 $26K
0004A 1,318 1,303 $26K
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 1,079 557 $26K
84520 7,300 6,956 $26K
J1940 Injection, furosemide, up to 20 mg 4,072 2,012 $25K
82952 4,206 4,144 $24K
95810 Polysomnography; sleep staging with 4 or more additional parameters 42 42 $24K
84075 5,218 4,905 $24K
J9045 Injection, carboplatin, 50 mg 471 312 $24K
0003A 1,241 1,230 $24K
86160 977 917 $23K
J2916 Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg 334 203 $23K
96411 270 196 $23K
82248 5,199 3,809 $23K
J9267 Injection, paclitaxel, 1 mg 459 244 $23K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 636 614 $23K
J0290 Injection, ampicillin sodium, 500 mg 2,303 1,033 $22K
96368 560 399 $22K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 70 67 $22K
90480 860 808 $22K
82043 3,836 3,756 $21K
72040 487 479 $21K
0072A 963 957 $21K
J3489 Injection, zoledronic acid, 1 mg 120 118 $21K
J1170 Injection, hydromorphone, up to 4 mg 5,051 3,172 $21K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 583 561 $21K
11721 291 285 $21K
86708 1,507 1,463 $21K
85730 4,033 3,443 $20K
86592 4,332 4,151 $20K
92025 303 300 $20K
0071A 949 936 $20K
90746 224 214 $20K
77065 Tomosynthesis, mammo 266 260 $20K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 11,906 11,057 $19K
86922 62 55 $19K
0124A 917 908 $18K
93296 599 592 $18K
51705 110 103 $18K
80069 2,356 2,125 $18K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 126 122 $18K
J2785 Injection, regadenoson, 0.1 mg 103 102 $18K
90697 230 218 $17K
84481 1,011 980 $17K
J2405 Injection, ondansetron hydrochloride, per 1 mg 11,949 8,770 $17K
80197 1,591 946 $16K
0054A 690 681 $16K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,008 983 $16K
J3475 Injection, magnesium sulfate, per 500 mg 1,616 1,137 $16K
80320 1,201 1,124 $16K
73070 529 487 $16K
86787 1,351 1,318 $15K
74018 553 490 $15K
83721 1,679 1,632 $15K
73562 387 371 $14K
97535 Self-care/home management training, each 15 minutes 610 492 $14K
0012A 548 544 $14K
82550 2,258 1,923 $14K
77080 494 477 $14K
36561 12 12 $14K
83615 2,184 1,842 $14K
87081 1,465 1,422 $14K
11720 637 627 $13K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 1,329 1,284 $13K
72128 108 107 $13K
77091 616 582 $13K
G0382 Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 828 786 $13K
88112 247 220 $13K
85045 2,675 2,238 $13K
96402 485 455 $13K
52000 25 25 $12K
C1769 Guide wire 958 900 $12K
82977 1,635 1,587 $12K
83540 1,782 1,729 $12K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 407 398 $12K
83020 860 684 $11K
70486 92 90 $11K
73060 376 316 $11K
73521 276 268 $11K
86696 587 559 $11K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 150 148 $11K
85384 1,315 1,176 $11K
87205 2,444 2,146 $11K
93289 354 349 $10K
86038 852 831 $10K
92567 483 472 $10K
99381 589 584 $10K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 26 25 $10K
94660 35 25 $10K
J1885 Injection, ketorolac tromethamine, per 15 mg 3,270 2,960 $10K
64643 13 12 $10K
87631 82 79 $10K
J0780 Injection, prochlorperazine, up to 10 mg 615 550 $10K
0011A 519 514 $10K
74178 38 38 $9K
J3480 Injection, potassium chloride, per 2 meq 668 448 $9K
73565 235 231 $9K
85651 2,299 2,165 $9K
99152 358 345 $9K
73090 296 281 $9K
J2270 Injection, morphine sulfate, up to 10 mg 3,348 2,770 $9K
87070 1,166 1,012 $9K
80177 521 506 $8K
84165 924 867 $8K
97803 262 256 $8K
84132 2,285 2,173 $8K
86705 714 687 $8K
92136 214 211 $8K
97163 84 75 $8K
90680 299 278 $7K
84155 2,183 2,064 $7K
G0378 Hospital observation service, per hour 1,506 1,189 $7K
G0383 Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 399 372 $7K
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 468 423 $7K
84550 1,673 1,585 $7K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 733 667 $7K
J3411 Injection, thiamine hcl, 100 mg 979 768 $7K
97760 97 93 $6K
90686 397 392 $6K
80164 467 430 $6K
J1815 Injection, insulin, per 5 units 1,979 390 $6K
86593 1,142 1,084 $6K
86304 367 312 $6K
10060 27 27 $6K
J0690 Injection, cefazolin sodium, 500 mg 1,406 1,180 $6K
72156 13 12 $6K
84300 1,307 1,197 $6K
97802 100 99 $6K
82310 1,361 1,310 $6K
87493 158 152 $6K
72157 14 13 $6K
72197 12 12 $6K
86695 438 417 $5K
90687 1,370 1,337 $5K
90662 648 640 $5K
93325 24 24 $5K
0064A 236 236 $5K
86225 353 340 $5K
86301 283 233 $5K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 850 773 $5K
80143 290 274 $5K
87075 639 542 $5K
92550 104 104 $5K
J0692 Injection, cefepime hydrochloride, 500 mg 163 81 $5K
49082 21 12 $5K
82239 303 270 $5K
41899 Unlisted procedure, dentoalveolar structures 49 42 $5K
72170 171 163 $5K
84295 1,258 1,191 $5K
76882 135 126 $5K
87517 98 88 $4K
83520 252 225 $4K
86902 26 25 $4K
90716 159 145 $4K
0052A 130 128 $4K
J1630 Injection, haloperidol, up to 5 mg 899 658 $4K
78451 15 15 $4K
82140 363 326 $4K
83010 366 318 $4K
82533 260 220 $4K
99153 Mod sedat endo service >5yrs 118 116 $4K
95819 12 12 $4K
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 665 645 $4K
87634 43 42 $4K
76376 13 12 $4K
36430 1,233 881 $4K
G0475 Hiv antigen/antibody, combination assay, screening 2,647 2,585 $4K
J2791 Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu 166 162 $3K
0053A 116 113 $3K
93990 90 87 $3K
80361 126 122 $3K
87430 146 140 $3K
80179 177 169 $3K
0051A 107 105 $3K
Q3014 Telehealth originating site facility fee 148 141 $3K
C9257 Injection, bevacizumab, 0.25 mg 605 588 $3K
85652 1,221 1,158 $3K
92610 50 50 $3K
80047 235 228 $3K
80365 138 134 $3K
90791 Psychiatric diagnostic evaluation 45 40 $3K
90633 470 426 $3K
A9585 Injection, gadobutrol, 0.1 ml 3,424 3,311 $3K
J3010 Injection, fentanyl citrate, 0.1 mg 4,290 3,741 $3K
J2060 Injection, lorazepam, 2 mg 1,302 979 $3K
82374 668 645 $3K
90651 30 28 $3K
29125 38 36 $3K
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,547 1,120 $3K
83935 431 400 $3K
88304 26 24 $2K
87338 217 216 $2K
82435 663 646 $2K
89051 585 447 $2K
93321 26 26 $2K
76870 27 25 $2K
86431 431 418 $2K
J2800 Injection, methocarbamol, up to 10 ml 170 146 $2K
83521 320 291 $2K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 98 95 $2K
84540 490 452 $2K
92250 70 68 $2K
C2629 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, laser 231 219 $2K
98967 278 269 $2K
96377 51 40 $2K
90714 78 75 $2K
J2175 Injection, meperidine hydrochloride, per 100 mg 493 402 $2K
J2250 Injection, midazolam hydrochloride, per 1 mg 2,947 2,715 $2K
11102 24 24 $2K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 379 321 $2K
86200 137 132 $2K
76512 46 37 $2K
90739 13 13 $2K
72070 42 40 $2K
J2704 Injection, propofol, 10 mg 4,644 3,364 $2K
0134A 67 65 $1K
82784 135 127 $1K
87045 148 141 $1K
88307 39 39 $1K
86256 89 83 $1K
69210 26 26 $1K
80202 124 100 $1K
87529 12 12 $1K
82088 37 37 $1K
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 3,843 3,109 $1K
A9270 Non-covered item or service 35,019 10,226 $1K
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg 193 150 $1K
87209 71 68 $1K
J0171 Injection, adrenalin, epinephrine, 0.1 mg 296 216 $1K
87581 26 25 $1K
87486 26 25 $1K
82664 16 16 $1K
82024 28 25 $1K
85460 145 135 $1K
57454 12 12 $1K
84133 235 218 $989.21
82436 205 190 $982.21
76000 28 24 $950.70
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 1,103 752 $895.91
82077 89 87 $887.16
91200 102 101 $858.26
C1887 Catheter, guiding (may include infusion/perfusion capability) 60 56 $851.18
83001 39 39 $835.50
97763 18 14 $823.93
73620 30 26 $804.03
J2765 Injection, metoclopramide hcl, up to 10 mg 549 457 $788.20
Q0169 Promethazine hydrochloride, 12.5 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 1,487 1,389 $733.83
90734 42 39 $729.06
0081A 13 13 $718.80
J0330 Injection, succinylcholine chloride, up to 20 mg 81 79 $711.97
90853 Group psychotherapy (other than of a multiple-family group) 18 12 $676.96
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 113 107 $674.87
86709 118 116 $671.10
90707 86 79 $661.70
87177 83 80 $647.95
86039 68 67 $635.79
90834 Psychotherapy, 45 minutes with patient 14 12 $627.33
82330 155 141 $626.21
83883 34 33 $612.04
73140 12 12 $598.68
J0360 Injection, hydralazine hcl, up to 20 mg 74 65 $567.51
84146 26 26 $548.63
J0610 Injection, calcium gluconate (fresenius kabi), per 10 ml 47 37 $510.21
80156 13 13 $463.43
76937 12 12 $447.80
82746 27 27 $446.00
J0595 Injection, butorphanol tartrate, 1 mg 75 57 $445.37
84157 148 121 $443.00
97597 36 24 $436.86
88185 16 16 $432.56
88184 16 16 $432.56
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 280 265 $427.30
90647 528 512 $424.96
11900 12 12 $424.55
87116 44 24 $400.19
90673 91 90 $397.86
J3490 Unclassified drugs 89 72 $395.63
80329 28 27 $387.90
96379 28 24 $362.72
A9503 Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries 16 16 $357.41
93288 24 24 $308.11
90474 132 132 $298.22
84466 25 25 $279.90
80354 14 13 $279.34
J2370 Injection, phenylephrine hcl, up to 1 ml 669 596 $273.05
86300 13 12 $272.84
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 291 278 $265.02
86886 57 54 $242.52
86235 21 17 $238.65
80325 13 12 $228.44
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 170 162 $193.76
86702 14 14 $184.58
86701 28 27 $171.34
80359 13 12 $169.30
84134 13 13 $156.73
86880 26 26 $147.06
G0380 Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) 14 14 $140.56
87799 16 12 $137.70
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 16 15 $122.75
A6258 Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing 17 12 $115.78
82042 15 13 $114.88
J2919 Injection, methylprednisolone sodium succinate, 5 mg 28 24 $113.29
83930 16 14 $111.83
J1596 Injection, glycopyrrolate, 0.1 mg 142 137 $101.41
82010 17 12 $97.79
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 29 29 $77.30
J1836 Injection, metronidazole, 10 mg 33 16 $70.62
G0476 Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test 14 14 $61.03
83525 15 14 $60.84
J2795 Injection, ropivacaine hydrochloride, 1 mg 14 13 $48.35
G0008 Administration of influenza virus vaccine 3,249 3,213 $46.71
90700 88 75 $42.70
82465 13 12 $30.63
S0030 Injection, metronidazole, 500 mg 40 24 $14.27
G0009 Administration of pneumococcal vaccine 980 967 $6.80
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg 16 12 $4.96
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 30 26 $2.08
91300 18,253 15,990 $0.01
3078F 5,389 5,016 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 731 588 $0.00
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 108 108 $0.00
90681 211 210 $0.00
77062 163 163 $0.00
91313 68 66 $0.00
91312 931 922 $0.00
91308 60 60 $0.00
90611 29 28 $0.00
98966 311 306 $0.00
99051 13 13 $0.00
77061 44 44 $0.00
90685 12 12 $0.00
98968 115 113 $0.00
Q9957 Injection, perflutren lipid microspheres, per ml 15 15 $0.00
3074F 5,295 4,936 $0.00
C1889 Implantable/insertable device, not otherwise classified 29 28 $0.00
G0103 Prostate cancer screening; prostate specific antigen test (psa) 568 555 $0.00
3044F 98 83 $0.00
91307 2,013 1,849 $0.00
A9561 Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries 126 126 $0.00
91305 928 898 $0.00
90723 252 251 $0.00
91306 114 114 $0.00
91301 713 691 $0.00
90674 38 38 $0.00
J7999 Compounded drug, not otherwise classified 317 299 $0.00
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 15 14 $0.00
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision 56 55 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 129 107 $0.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 15 12 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 99 85 $0.00
J3471 Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units) 39 39 $0.00
V2632 Posterior chamber intraocular lens 15 15 $0.00
3075F 13 12 $0.00
91318 28 27 $0.00
J7644 Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram 20 14 $0.00
3079F 15 14 $0.00