Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OH › GALLIPOLIS › HOLZER HOSPITAL FOUNDATION

HOLZER HOSPITAL FOUNDATION

NPI: 1942256888 · GALLIPOLIS, OH 45631 · Clinical Medical Laboratory · NPI assigned 05/25/2006

$121.51M
Total Medicaid Paid
1,946,441
Total Claims
1,636,520
Beneficiaries
503
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSTOUT, RODNEY (CEO)
NPI Enumeration Date05/25/2006

Related Entities

Other providers sharing the same authorized official: STOUT, RODNEY

ProviderCityStateTotal Paid
HOLZER HOSPITAL FOUNDATION GALLIPOLIS OH $1.04M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 244,361 $10.28M
2019 228,833 $9.87M
2020 189,160 $13.79M
2021 198,759 $15.08M
2022 239,041 $19.41M
2023 502,548 $29.59M
2024 343,739 $23.51M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G0463 Hospital outpatient clinic visit for assessment and management of a patient 710,035 597,489 $74.72M
99284 Emergency department visit for the evaluation and management, high severity 33,136 29,732 $5.01M
99283 Emergency department visit for the evaluation and management, moderate severity 31,003 29,161 $4.67M
96361 Intravenous infusion, hydration; each additional hour 7,964 6,528 $2.82M
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 12,553 11,595 $2.44M
70450 Computed tomography, head or brain; without contrast material 5,230 4,787 $1.64M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 15,578 4,797 $1.53M
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 6,331 6,183 $1.38M
74177 Computed tomography, abdomen and pelvis; with contrast material 4,066 3,530 $1.28M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 2,578 2,422 $1.20M
0240U 5,504 5,124 $1.18M
99282 Emergency department visit for the evaluation and management, low to moderate severity 7,336 7,021 $946K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 462 429 $939K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 4,570 4,006 $750K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 1,927 1,064 $749K
74176 Computed tomography, abdomen and pelvis; without contrast material 2,122 1,877 $748K
J0585 Injection, onabotulinumtoxina, 1 unit 1,429 881 $706K
80053 Comprehensive metabolic panel 47,031 42,350 $698K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 3,939 3,545 $697K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 3,804 3,203 $650K
99281 Emergency department visit for the evaluation and management, self-limited or minor 4,599 4,463 $547K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 641 572 $493K
71275 Computed tomographic angiography, chest, with contrast material 1,183 984 $483K
59025 Fetal non-stress test 2,588 1,516 $457K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,203 1,126 $432K
95810 Polysomnography; sleep staging with 4 or more additional parameters 508 484 $404K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 90,159 77,116 $374K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 446 386 $364K
20610 2,342 2,095 $333K
36415 Collection of venous blood by venipuncture 107,894 93,130 $315K
84443 Thyroid stimulating hormone (TSH) 21,428 19,969 $309K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 409 372 $302K
95886 1,304 1,108 $265K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 2,686 1,532 $262K
76830 Ultrasound, transvaginal 1,678 1,568 $258K
80048 Basic metabolic panel (calcium, ionized) 31,806 27,140 $254K
97530 Therapeutic activities, direct patient contact, each 15 minutes 3,583 1,510 $240K
97597 2,307 1,270 $240K
76705 Ultrasound, abdominal, real time with image documentation; limited 1,569 1,449 $235K
81003 14,456 12,216 $219K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 768 669 $199K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 1,716 970 $196K
64615 544 487 $192K
80061 Lipid panel 15,845 14,978 $191K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 416 387 $181K
95117 4,829 2,133 $181K
71046 Radiologic examination, chest; 2 views 8,800 8,057 $179K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 1,444 554 $175K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 469 451 $163K
71260 Computed tomography, thorax, diagnostic; with contrast material 751 663 $155K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 32,311 24,740 $154K
71271 635 604 $148K
77067 Screening mammography, bilateral, including computer-aided detection 2,134 1,976 $146K
J1050 Injection, medroxyprogesterone acetate, 1 mg 1,917 1,711 $138K
G0378 Hospital observation service, per hour 2,960 2,002 $138K
83036 Hemoglobin; glycosylated (A1C) 12,569 11,935 $135K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 7,344 6,855 $132K
62323 263 227 $131K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 114 104 $130K
92557 1,398 1,323 $130K
81001 27,621 24,934 $127K
76536 859 807 $126K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 5,057 4,005 $124K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 22,336 19,281 $122K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 1,893 818 $110K
47562 29 26 $109K
76770 478 452 $102K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 1,895 1,633 $95K
90460 Immunization administration through 18 years of age via any route, first or only component 7,567 6,775 $95K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 738 424 $91K
97161 1,285 1,203 $91K
81025 9,349 8,387 $88K
93017 619 568 $88K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 26,234 13,768 $87K
45380 Colonoscopy, flexible; with biopsy, single or multiple 204 177 $87K
76642 535 480 $86K
86850 3,022 2,746 $81K
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis 140 126 $77K
94060 1,566 1,510 $74K
71250 951 852 $72K
84484 16,318 11,790 $71K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 243 231 $69K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 5,961 5,556 $69K
73630 4,758 4,160 $68K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 1,758 1,715 $66K
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 9,212 8,396 $65K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 1,618 1,467 $60K
80076 13,615 12,059 $59K
90686 4,131 3,760 $57K
72110 1,674 1,562 $55K
87507 545 503 $54K
80069 2,287 2,104 $54K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 27,404 25,930 $53K
93971 461 423 $53K
85610 11,360 9,869 $51K
90670 1,985 1,762 $51K
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 6,035 5,942 $50K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 5,964 5,558 $50K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 618 267 $50K
98940 1,718 1,007 $49K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 461 415 $49K
84439 3,729 3,452 $47K
70491 113 98 $47K
70551 Magnetic resonance imaging, brain; without contrast material 179 167 $46K
96367 466 356 $46K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 713 661 $46K
82607 4,909 4,556 $45K
82553 6,410 4,984 $45K
73221 149 141 $45K
90677 538 500 $44K
87902 194 162 $44K
70486 424 387 $44K
87086 Culture, bacterial; quantitative colony count, urine 8,115 7,219 $44K
G0481 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; 8-14 drug class(es), including metabolite(s) if performed 583 423 $41K
76000 281 236 $41K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 12,333 10,858 $40K
90715 2,267 2,024 $39K
96368 720 473 $39K
42820 Tonsillectomy and adenoidectomy; younger than age 12 14 14 $38K
88305 Level IV - Surgical pathology, gross and microscopic examination 8,594 4,969 $38K
97162 578 538 $38K
92133 892 843 $37K
31575 179 158 $37K
71045 Radiologic examination, chest; single view 8,531 7,767 $37K
73610 2,186 1,924 $37K
92567 1,591 1,477 $36K
73130 1,927 1,663 $36K
77063 Screening digital breast tomosynthesis, bilateral 1,808 1,685 $36K
87340 2,737 2,478 $36K
86140 7,317 6,495 $35K
73562 2,237 2,005 $35K
73110 1,372 1,172 $34K
12001 154 139 $34K
72050 887 833 $34K
98941 Chiropractic manipulative treatment; spinal, 3-4 regions 701 448 $34K
93975 131 118 $33K
80306 1,922 1,589 $32K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 2,242 2,074 $32K
84702 1,610 1,096 $32K
86780 2,364 2,156 $32K
87522 Neg quan hep c or qual rna 951 853 $32K
94729 1,458 1,406 $31K
94726 1,459 1,406 $31K
86803 2,681 2,427 $31K
87420 1,410 1,304 $28K
82550 7,088 5,522 $27K
17110 339 299 $27K
85730 8,489 7,409 $27K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 9,448 8,077 $26K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 1,047 764 $26K
43235 57 55 $25K
72131 177 167 $25K
82746 4,416 4,097 $25K
72125 Computed tomography, cervical spine; without contrast material 1,010 911 $25K
83655 1,251 1,141 $25K
93458 15 12 $25K
88304 607 478 $25K
96127 272 145 $25K
93242 442 421 $25K
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 1,125 967 $23K
73030 1,750 1,594 $23K
82570 3,056 2,815 $23K
74018 1,637 1,462 $22K
86900 1,351 1,180 $22K
77080 228 212 $21K
96375 Therapeutic injection; each additional sequential IV push 6,849 5,454 $21K
80320 1,330 1,031 $21K
89190 2,466 2,400 $21K
82728 1,831 1,657 $20K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials 610 423 $20K
70498 81 72 $20K
10060 95 82 $19K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 1,971 1,795 $19K
74178 52 45 $18K
83540 2,811 2,592 $18K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 3,144 2,896 $17K
83605 5,251 3,932 $17K
86709 978 866 $17K
11981 57 53 $17K
86480 367 343 $16K
76882 119 109 $16K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 2,245 2,159 $16K
83690 9,403 8,137 $16K
83735 3,992 3,102 $16K
83550 2,589 2,397 $15K
84156 1,888 1,686 $15K
77066 Tomosynthesis, mammo 260 239 $15K
G0482 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; 15-21 drug class(es), including metabolite(s) if performed 241 233 $15K
J0558 Injection, penicillin g benzathine and penicillin g procaine, 100,000 units 67 43 $14K
72072 596 576 $14K
73502 837 778 $14K
82947 2,622 2,428 $14K
86706 1,164 1,054 $14K
J0561 Injection, penicillin g benzathine, 100,000 units 58 41 $14K
76700 Ultrasound, abdominal, real time with image documentation; complete 53 51 $14K
83970 531 458 $14K
J2405 Injection, ondansetron hydrochloride, per 1 mg 11,709 9,502 $14K
86762 828 764 $13K
90648 2,904 2,665 $13K
97598 49 25 $13K
70496 82 73 $13K
86376 964 907 $13K
97166 168 156 $13K
20605 62 52 $13K
87186 4,085 3,061 $12K
87070 1,949 1,767 $12K
J3490 Unclassified drugs 1,969 1,476 $12K
87077 4,149 3,087 $12K
81596 61 56 $12K
92587 127 124 $12K
90723 2,082 1,918 $11K
51798 548 523 $11K
85018 2,365 2,118 $11K
90633 1,735 1,532 $11K
90651 1,151 1,079 $11K
73080 683 575 $11K
87210 1,018 928 $11K
90837 Psychotherapy, 53 minutes with patient 61 50 $11K
74019 634 586 $10K
86705 710 634 $10K
86704 613 547 $10K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 32 27 $10K
G0008 Administration of influenza virus vaccine 4,569 4,359 $10K
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 531 472 $10K
99174 186 178 $10K
86038 1,056 911 $10K
76819 Fetal biophysical profile; without non-stress testing 374 173 $10K
82247 579 323 $10K
90734 1,210 1,110 $9K
92134 333 308 $9K
86003 1,306 564 $9K
31237 20 14 $9K
93296 639 591 $9K
85652 3,258 2,972 $9K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,871 1,593 $9K
31231 46 42 $9K
84112 107 87 $9K
93880 73 69 $8K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,254 1,084 $8K
82962 3,864 1,151 $8K
64493 34 28 $8K
95811 24 24 $8K
11750 69 52 $8K
86364 1,149 540 $8K
86901 1,351 1,180 $8K
82784 1,343 815 $7K
73590 463 412 $7K
82043 1,188 1,127 $7K
82785 874 813 $7K
99152 361 292 $7K
J1885 Injection, ketorolac tromethamine, per 15 mg 11,092 9,357 $7K
84436 757 689 $7K
84100 823 552 $7K
84403 520 429 $7K
74183 27 24 $7K
82248 706 557 $6K
94010 1,518 1,464 $6K
80361 568 318 $6K
90656 555 554 $6K
73140 391 364 $6K
86430 946 761 $6K
11982 34 27 $6K
84153 416 403 $6K
83880 1,770 1,535 $6K
71101 322 293 $5K
80346 457 231 $5K
84402 325 294 $5K
G0127 Trimming of dystrophic nails, any number 317 313 $5K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,023 899 $5K
80324 488 240 $5K
86258 801 375 $5K
87150 485 451 $5K
90716 548 519 $5K
90696 755 695 $5K
83001 394 356 $5K
87040 2,956 1,433 $4K
90710 862 797 $4K
86757 1,308 609 $4K
84479 654 595 $4K
84550 1,149 938 $4K
86618 767 705 $4K
H1003 Prenatal care, at-risk enhanced service; education 197 172 $4K
82565 722 551 $4K
84481 397 373 $4K
83992 275 155 $4K
84270 313 284 $4K
73090 372 319 $4K
90791 Psychiatric diagnostic evaluation 13 13 $4K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 470 352 $4K
80365 433 218 $4K
86231 408 376 $4K
90700 610 579 $4K
96376 1,289 826 $4K
84146 267 244 $4K
99406 193 186 $4K
95912 69 67 $4K
90662 304 298 $4K
80348 535 256 $4K
90707 571 517 $3K
J7050 Infusion, normal saline solution, 250 cc 5,607 3,060 $3K
86235 385 170 $3K
83993 121 113 $3K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 486 224 $3K
77002 16 14 $3K
86666 700 303 $3K
93970 15 12 $3K
80350 275 155 $3K
73560 176 152 $3K
20550 16 15 $3K
73564 151 127 $3K
12002 12 12 $3K
11721 215 208 $3K
74022 221 198 $3K
82274 151 136 $3K
90681 983 899 $3K
86580 98 82 $3K
83615 758 581 $3K
80356 357 197 $3K
94664 925 714 $3K
86008 428 370 $3K
80349 322 173 $3K
80354 349 183 $3K
80353 414 203 $3K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 4,469 3,684 $2K
95909 63 60 $2K
86317 143 53 $2K
93922 15 13 $2K
99153 Mod sedat endo service >5yrs 356 205 $2K
82040 313 268 $2K
93270 26 25 $2K
84703 661 562 $2K
72100 36 29 $2K
83721 248 234 $2K
85379 1,703 1,493 $2K
J0897 Injection, denosumab, 1 mg 13 12 $2K
80373 275 155 $2K
82105 419 388 $2K
85384 604 553 $2K
00840 188 144 $2K
64450 14 12 $2K
85014 856 787 $2K
81000 320 288 $2K
82150 2,335 2,046 $2K
86200 199 184 $2K
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 940 818 $2K
97116 42 24 $2K
00731 1,041 951 $2K
73552 118 104 $2K
85027 511 414 $2K
86225 208 189 $2K
J0696 Injection, ceftriaxone sodium, per 250 mg 3,503 2,805 $2K
84165 301 276 $2K
86696 323 278 $2K
84460 436 280 $1K
86695 307 275 $1K
86665 219 96 $1K
86708 134 121 $1K
84450 393 261 $1K
86308 401 341 $1K
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 1,734 1,242 $1K
80360 143 48 $1K
80355 263 143 $1K
80358 275 155 $1K
73060 63 57 $1K
96523 33 26 $1K
82670 96 88 $1K
92083 42 41 $1K
76870 70 59 $1K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 412 375 $1K
J2704 Injection, propofol, 10 mg 7,485 6,484 $1K
80164 47 44 $1K
86753 283 257 $1K
82977 126 79 $1K
82731 15 12 $977.75
G0009 Administration of pneumococcal vaccine 731 681 $944.20
76820 56 27 $923.98
85007 488 395 $880.21
73521 35 33 $850.29
80362 88 32 $828.88
86160 74 33 $805.67
82140 184 142 $801.23
84145 348 293 $749.05
82803 798 605 $748.13
J1170 Injection, hydromorphone, up to 4 mg 1,928 1,350 $726.10
90732 24 24 $709.91
80047 150 133 $679.15
95024 327 320 $656.87
00170 Anesthesia for intraoral procedures, including biopsy 480 415 $636.91
82533 16 13 $623.60
29125 181 150 $620.29
88342 1,607 1,309 $617.19
86664 113 98 $604.80
69210 233 223 $595.29
J2270 Injection, morphine sulfate, up to 10 mg 1,766 1,323 $588.76
80329 396 320 $571.02
00126 237 223 $566.97
J7030 Infusion, normal saline solution , 1000 cc 5,203 3,640 $542.14
84207 102 96 $497.90
J2785 Injection, regadenoson, 0.1 mg 218 187 $480.61
77065 Tomosynthesis, mammo 12 12 $478.55
00813 1,072 940 $478.50
83520 39 29 $467.20
J7120 Ringers lactate infusion, up to 1000 cc 3,767 2,935 $461.01
87641 37 37 $460.15
11055 14 12 $452.08
36600 165 137 $447.90
72081 14 13 $433.37
87205 486 460 $432.09
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 4,724 3,958 $427.70
87338 12 12 $364.76
84520 89 56 $358.56
69209 411 364 $358.33
86677 60 52 $354.77
J1644 Injection, heparin sodium, per 1000 units 1,328 715 $349.48
86738 13 13 $334.36
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 4,145 3,655 $325.26
86703 41 39 $281.75
J1815 Injection, insulin, per 5 units 124 60 $272.58
84480 12 12 $271.27
80345 15 15 $265.66
90620 51 48 $251.78
J3486 Injection, ziprasidone mesylate, 10 mg 17 12 $247.74
86334 15 14 $240.58
J0690 Injection, cefazolin sodium, 500 mg 1,377 1,129 $220.54
92504 1,328 1,188 $218.15
J2360 Injection, orphenadrine citrate, up to 60 mg 494 397 $213.18
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 198 109 $208.60
83002 14 13 $207.38
36416 358 309 $201.00
J1650 Injection, enoxaparin sodium, 10 mg 197 86 $200.10
84425 24 24 $199.15
82375 178 134 $185.58
85045 57 54 $182.89
J1040 Injection, methylprednisolone acetate, 80 mg 1,173 969 $161.32
01992 299 247 $151.28
90381 14 14 $143.80
88341 17 12 $142.92
J3010 Injection, fentanyl citrate, 0.1 mg 3,797 3,188 $132.37
J2919 Injection, methylprednisolone sodium succinate, 5 mg 1,296 1,174 $118.28
73565 33 29 $115.82
J2550 Injection, promethazine hcl, up to 50 mg 476 363 $96.77
J2175 Injection, meperidine hydrochloride, per 100 mg 399 342 $92.75
83090 12 12 $91.84
92136 12 12 $91.31
J3370 Injection, vancomycin hcl, 500 mg 111 59 $90.59
G0103 Prostate cancer screening; prostate specific antigen test (psa) 259 240 $88.05
J2250 Injection, midazolam hydrochloride, per 1 mg 3,048 2,537 $71.39
J1200 Injection, diphenhydramine hcl, up to 50 mg 881 676 $60.33
82103 13 13 $52.03
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 294 200 $44.37
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 3,127 2,845 $43.06
J2060 Injection, lorazepam, 2 mg 459 348 $39.28
A9585 Injection, gadobutrol, 0.1 ml 940 831 $39.10
86774 13 13 $38.60
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 761 568 $32.13
J2765 Injection, metoclopramide hcl, up to 10 mg 446 372 $30.96
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 469 429 $29.72
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 790 728 $28.45
G0379 Direct admission of patient for hospital observation care 332 297 $20.00
J3475 Injection, magnesium sulfate, per 500 mg 22 13 $19.14
J1010 Injection, methylprednisolone acetate, 1 mg 494 450 $11.88
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 346 244 $11.00
J2470 Injection, pantoprazole sodium, 40 mg 38 31 $7.19
J3480 Injection, potassium chloride, per 2 meq 566 306 $6.65
J1790 Injection, droperidol, up to 5 mg 81 72 $6.42
94760 527 248 $4.55
91320 27 27 $4.34
J0330 Injection, succinylcholine chloride, up to 20 mg 44 30 $4.02
J7060 5% dextrose/water (500 ml = 1 unit) 181 89 $3.48
J0171 Injection, adrenalin, epinephrine, 0.1 mg 149 111 $2.96
J1171 Injection, hydromorphone, 0.1 mg 94 84 $2.70
J1940 Injection, furosemide, up to 20 mg 19 12 $1.16
Q0163 Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen 98 77 $1.13
J1596 Injection, glycopyrrolate, 0.1 mg 210 203 $0.64
91300 20 16 $0.15
C1773 Retrieval device, insertable (used to retrieve fractured medical devices) 199 192 $0.00
A9270 Non-covered item or service 793 602 $0.00
00142 41 38 $0.00
90480 70 70 $0.00
01480 18 13 $0.00
C1769 Guide wire 633 358 $0.00
J0173 Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mg 162 153 $0.00
C1766 Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away 174 124 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 229 224 $0.00
95012 25 25 $0.00
J1030 Injection, methylprednisolone acetate, 40 mg 54 52 $0.00
00790 37 25 $0.00
00952 19 14 $0.00
Q9960 High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml 474 413 $0.00
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 270 247 $0.00
00812 72 66 $0.00
00811 453 365 $0.00
80305 30 12 $0.00
90671 662 648 $0.00
C1887 Catheter, guiding (may include infusion/perfusion capability) 214 121 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 296 194 $0.00
01810 90 75 $0.00
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 87 70 $0.00
H1000 Prenatal care, at-risk assessment 197 172 $0.00
92015 Determination of refractive state 53 51 $0.00
C1760 Closure device, vascular (implantable/insertable) 14 13 $0.00
A4649 Surgical supply; miscellaneous 13 12 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 24 16 $0.00