Medicaid Provider Spending

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

KADLEC REGIONAL MEDICAL CENTER

NPI: 1972507580 · RICHLAND, WA 99352 · General Acute Care Hospital · NPI assigned 06/10/2005

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

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

$151.60M
Total Medicaid Paid
3,639,406
Total Claims
3,056,908
Beneficiaries
703
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialANDERSON, DONALD (ASSISTANT SECREATRY FOR ENROLLMENT)
NPI Enumeration Date06/10/2005

Related Entities

Other providers sharing the same authorized official: ANDERSON, DONALD

ProviderCityStateTotal Paid
PROVIDENCE HEALTH & SERVICES WASHINGTON ANCHORAGE AK $161.45M
SWEDISH EDMONDS EDMONDS WA $30.06M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC EUREKA CA $28.68M
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA TORRANCE CA $27.29M
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA SAN PEDRO CA $24.26M
PROVIDENCE HEALTH & SERVICES - WASHINGTON TUKWILA WA $21.98M
SWEDISH HEALTH SERVICES SEATTLE WA $21.06M
PROVIDENCE HEALTH & SERVICES WASHINGTON KODIAK AK $11.39M
SWEDISH HEALTH SERVICES SEATTLE WA $11.08M
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC FORTUNA CA $8.55M
COLLABRIA CARE NAPA CA $8.20M
PROVIDENCE HEALTH & SERVICES OREGON SEASIDE OR $8.01M
PROVIDENCE HEALTH & SERVICES- WASHINGTON SPOKANE WA $8.01M
HOSPICE OF LUBBOCK INC LUBBOCK TX $6.48M
PROVIDENCE SAINT JOHN'S HEALTH CENTER SANTA MONICA CA $5.52M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.55M
COLLABRIA CARE NAPA CA $4.05M
METHODIST HOSPITAL LEVELLAND LEVELLAND TX $4.01M
METHODIST HOSPITAL PLAINVIEW TEXAS PLAINVIEW TX $4.00M
PROVIDENCE MEDICAL INSTITUTE TORRANCE CA $3.57M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 639,733 $26.64M
2019 580,197 $24.15M
2020 464,038 $18.26M
2021 523,547 $20.52M
2022 517,790 $22.78M
2023 499,227 $20.78M
2024 414,874 $18.47M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G0463 Hospital outpatient clinic visit for assessment and management of a patient 377,050 310,562 $31.71M
99283 Emergency department visit for the evaluation and management, moderate severity 117,675 110,898 $13.96M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 240,161 228,502 $11.78M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 193,321 185,262 $8.20M
96361 Intravenous infusion, hydration; each additional hour 26,319 23,111 $7.99M
99284 Emergency department visit for the evaluation and management, high severity 69,187 64,105 $6.40M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 41,662 38,621 $3.59M
J9271 Injection, pembrolizumab, 1 mg 695 526 $2.84M
74177 Computed tomography, abdomen and pelvis; with contrast material 13,239 12,800 $2.29M
99282 Emergency department visit for the evaluation and management, low to moderate severity 21,020 20,189 $1.88M
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 39,284 16,641 $1.72M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 20,558 20,454 $1.64M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 16,489 11,604 $1.62M
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 56,140 22,580 $1.57M
97530 Therapeutic activities, direct patient contact, each 15 minutes 38,363 18,196 $1.45M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 15,148 14,498 $1.45M
99281 Emergency department visit for the evaluation and management, self-limited or minor 10,488 10,185 $1.41M
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 17,786 11,003 $1.35M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 17,365 17,034 $1.27M
70450 Computed tomography, head or brain; without contrast material 9,138 8,770 $1.24M
44970 381 378 $1.17M
99233 Prolong inpt eval add15 m 29,160 12,728 $1.13M
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 7,996 7,328 $1.07M
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 4,420 3,129 $1.05M
74176 Computed tomography, abdomen and pelvis; without contrast material 5,408 5,260 $947K
76705 Ultrasound, abdominal, real time with image documentation; limited 10,524 10,264 $918K
99232 Subsequent hospital care, per day, moderate complexity 31,326 11,893 $882K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 7,816 3,306 $865K
99215 Prolong outpt/office vis 12,228 11,619 $859K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 4,549 4,321 $794K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 9,232 9,208 $769K
99479 Subsequent intensive care, per day, very low birth weight infant 9,948 2,160 $737K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 2,254 2,157 $710K
96415 3,763 2,700 $704K
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 10,112 9,659 $704K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 3,074 3,023 $681K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 11,279 11,139 $627K
76830 Ultrasound, transvaginal 8,920 8,696 $598K
99223 Prolong inpt eval add15 m 7,883 7,623 $575K
71275 Computed tomographic angiography, chest, with contrast material 3,612 3,512 $555K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 9,756 8,714 $547K
J0585 Injection, onabotulinumtoxina, 1 unit 2,870 2,387 $537K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 7,650 7,511 $533K
17110 3,067 2,804 $529K
12001 2,573 2,545 $521K
99480 Subsequent intensive care, per day, low birth weight infant 5,853 1,569 $425K
80053 Comprehensive metabolic panel 92,593 78,321 $422K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 19,802 8,601 $421K
96367 6,485 3,992 $415K
70551 Magnetic resonance imaging, brain; without contrast material 2,263 2,211 $409K
62323 2,965 2,690 $403K
64615 2,460 2,401 $401K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 14,183 6,471 $392K
90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits 6,152 6,005 $380K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 5,063 3,383 $376K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 11,746 10,795 $362K
12011 1,620 1,602 $356K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 3,928 3,823 $356K
97113 7,227 2,941 $353K
76775 4,347 4,280 $352K
76819 Fetal biophysical profile; without non-stress testing 6,827 3,967 $347K
78815 Positron emission tomography (PET) for limited area imaging 807 791 $345K
G0378 Hospital observation service, per hour 18,394 9,030 $333K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 2,817 2,788 $332K
59025 Fetal non-stress test 4,620 3,410 $332K
76642 4,141 3,871 $323K
J2323 Injection, natalizumab, 1 mg 311 272 $322K
J0129 Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) 549 470 $319K
96110 Developmental screening, with scoring and documentation, per standardized instrument 11,979 11,248 $315K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 6,442 5,808 $311K
99238 Hospital discharge day management, 30 minutes or less 6,534 6,384 $307K
93971 3,794 3,652 $302K
97161 6,865 6,692 $301K
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger 1,259 319 $299K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 4,428 4,375 $279K
92523 2,236 2,212 $278K
90686 19,639 19,517 $275K
92588 2,307 2,196 $272K
52000 503 488 $267K
99239 Hospital discharge day management, more than 30 minutes 6,526 6,306 $266K
96416 1,150 633 $265K
31575 1,869 1,839 $264K
99460 3,508 3,420 $254K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 2,716 2,659 $245K
76536 2,792 2,770 $237K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 4,390 4,150 $235K
92557 5,663 5,549 $225K
36902 200 190 $217K
76801 4,698 4,440 $217K
J2469 Injection, palonosetron hcl, 25 mcg 4,107 2,515 $208K
93017 2,415 2,340 $197K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 6,142 6,052 $193K
95819 964 947 $193K
87631 4,148 4,056 $188K
70498 1,615 1,559 $181K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 12,898 12,687 $180K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1,878 1,875 $178K
77067 Screening mammography, bilateral, including computer-aided detection 5,946 5,907 $176K
29105 864 841 $173K
90670 11,987 11,901 $164K
72141 1,376 1,365 $162K
10060 766 746 $159K
47563 77 74 $159K
92526 3,277 2,028 $158K
97535 Self-care/home management training, each 15 minutes 6,467 5,144 $157K
71046 Radiologic examination, chest; 2 views 27,943 26,811 $156K
93970 1,789 1,743 $148K
29125 836 808 $147K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 1,243 1,205 $146K
G6015 Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session 937 144 $146K
76870 1,618 1,566 $144K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,385 4,231 $144K
70496 1,667 1,612 $142K
70491 1,198 1,167 $139K
74183 643 630 $137K
92567 10,577 10,233 $136K
11045 510 257 $135K
J1602 Injection, golimumab, 1 mg, for intravenous use 289 154 $134K
45380 Colonoscopy, flexible; with biopsy, single or multiple 648 630 $133K
12002 659 655 $130K
J1453 Injection, fosaprepitant, 1 mg 1,519 978 $123K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 4,338 4,179 $121K
99244 Office or other outpatient consultation, moderate to high complexity 1,106 1,103 $118K
84484 27,684 22,004 $112K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 13,403 13,247 $107K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 10,251 5,973 $106K
95886 1,705 1,602 $106K
99205 Prolong outpt/office vis 946 923 $105K
71250 2,209 2,177 $105K
90834 Psychotherapy, 45 minutes with patient 1,708 1,288 $102K
90680 7,259 7,207 $100K
94726 3,181 3,126 $99K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 857 832 $98K
90961 1,340 1,312 $95K
94060 3,941 3,879 $95K
97162 2,356 2,301 $95K
77063 Screening digital breast tomosynthesis, bilateral 5,943 5,904 $92K
11102 598 566 $92K
20553 969 741 $92K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 304 294 $90K
97165 1,950 1,902 $87K
70486 1,661 1,634 $85K
90698 5,848 5,806 $84K
36430 895 595 $83K
20610 1,029 913 $80K
J1745 Injection, infliximab, excludes biosimilar, 10 mg 72 62 $80K
99222 Initial hospital care, per day, moderate complexity 1,517 1,466 $78K
76882 1,067 972 $78K
92579 1,744 1,687 $77K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 5,064 4,975 $74K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 8,299 7,255 $72K
76700 Ultrasound, abdominal, real time with image documentation; complete 701 692 $72K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 7,260 7,121 $71K
95816 429 421 $71K
90633 4,822 4,799 $66K
99243 942 938 $65K
87040 8,500 5,499 $65K
76937 2,329 2,112 $65K
77066 Tomosynthesis, mammo 2,585 2,562 $65K
77014 2,014 324 $64K
73630 10,238 8,526 $63K
71260 Computed tomography, thorax, diagnostic; with contrast material 3,468 3,385 $63K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 46,316 41,807 $63K
74018 5,458 5,179 $62K
97802 1,170 1,157 $62K
80048 Basic metabolic panel (calcium, ionized) 14,775 12,230 $61K
94729 3,390 3,333 $60K
J3490 Unclassified drugs 3,731 2,454 $60K
47562 44 40 $60K
76825 393 372 $59K
97803 1,692 1,243 $57K
10061 287 281 $57K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 28,332 21,806 $55K
69210 2,414 2,353 $54K
P9016 Red blood cells, leukocytes reduced, each unit 163 129 $54K
J0185 Injection, aprepitant, 1 mg 768 483 $53K
72125 Computed tomography, cervical spine; without contrast material 3,265 3,169 $51K
76821 1,003 437 $50K
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 5,592 5,090 $50K
92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder 3,769 1,655 $50K
58300 156 154 $50K
77065 Tomosynthesis, mammo 1,897 1,763 $49K
31231 330 327 $49K
90715 2,816 2,773 $49K
11100 240 227 $47K
83605 9,362 8,027 $46K
90832 Psychotherapy, 30 minutes with patient 1,208 949 $46K
72100 4,529 4,459 $45K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 3,835 3,756 $45K
76820 1,790 1,010 $44K
36561 40 40 $43K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 47,177 41,141 $42K
82553 6,004 5,438 $42K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 103,589 85,187 $41K
93975 552 542 $40K
58662 14 13 $40K
29515 213 204 $40K
92585 165 153 $40K
95911 364 334 $39K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 157 152 $39K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 12,300 10,715 $38K
99381 558 547 $38K
73030 4,843 4,515 $38K
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 47 46 $37K
90744 2,457 2,434 $37K
96375 Therapeutic injection; each additional sequential IV push 40,071 31,612 $36K
93880 965 940 $36K
76813 548 533 $35K
73562 4,975 4,829 $35K
72110 1,597 1,582 $35K
97116 2,246 1,169 $34K
73610 6,691 6,282 $33K
85379 6,479 6,293 $33K
36415 Collection of venous blood by venipuncture 36,983 25,169 $33K
11750 122 84 $33K
71045 Radiologic examination, chest; single view 22,465 21,107 $33K
73110 4,395 4,113 $32K
74230 391 386 $32K
92610 823 805 $31K
96040 765 732 $30K
77427 457 228 $29K
74174 148 141 $29K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 750 739 $27K
99462 801 687 $27K
97129 141 59 $26K
72040 2,324 2,289 $26K
97166 500 494 $25K
73130 4,102 3,791 $24K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 879 821 $24K
90677 1,566 1,558 $24K
90723 2,135 2,115 $23K
93922 706 687 $23K
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care 13 13 $23K
90472 Immunization administration, each additional vaccine (list separately) 976 967 $23K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 180 168 $23K
90648 1,807 1,798 $22K
96127 9,255 7,116 $22K
73221 222 219 $22K
83880 5,298 4,944 $22K
17000 172 167 $22K
84145 2,446 2,301 $21K
99309 Subsequent nursing facility care, per day, low to moderate complexity 3,665 2,199 $21K
93320 767 747 $21K
92587 130 126 $21K
87632 438 430 $20K
90966 260 258 $20K
11900 83 81 $19K
87641 2,160 2,091 $19K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 3,000 2,974 $19K
93798 3,215 603 $18K
99254 171 170 $17K
76827 420 398 $17K
20550 156 139 $16K
88307 923 906 $16K
73502 2,173 2,128 $16K
95909 247 234 $15K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 986 965 $15K
J9190 Injection, fluorouracil, 500 mg 1,209 656 $14K
72131 272 265 $14K
19083 27 25 $14K
77336 492 252 $14K
J2505 Injection, pegfilgrastim, 6 mg 18 14 $14K
99152 7,388 6,687 $14K
80050 General health panel 2,680 2,605 $14K
81001 56,693 51,957 $14K
58558 13 13 $13K
72197 76 76 $13K
88305 Level IV - Surgical pathology, gross and microscopic examination 6,450 6,195 $13K
90647 1,258 1,245 $13K
74178 89 87 $13K
87420 1,445 1,425 $12K
71271 170 169 $12K
90716 1,064 1,057 $12K
72158 107 104 $12K
99220 187 181 $12K
72146 57 55 $12K
93296 1,411 1,395 $12K
81025 15,743 15,127 $12K
90707 996 990 $12K
84112 1,570 1,407 $12K
87486 1,080 1,052 $11K
90962 266 260 $11K
83735 14,832 10,686 $11K
93000 1,311 1,281 $11K
72072 1,145 1,132 $11K
59820 12 12 $11K
99383 126 125 $11K
82247 1,929 1,306 $11K
77080 233 230 $11K
92551 1,395 1,384 $11K
90651 763 758 $10K
73140 2,726 2,638 $10K
J0561 Injection, penicillin g benzathine, 100,000 units 1,309 1,280 $10K
76770 125 123 $10K
64493 46 38 $10K
73560 997 940 $10K
86850 6,926 5,724 $9K
96111 52 39 $9K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 1,142 1,103 $9K
92611 365 359 $9K
90697 475 474 $9K
76857 203 198 $9K
87581 1,080 1,052 $9K
93976 257 253 $9K
29075 174 162 $9K
0071A 233 233 $8K
99443 179 164 $8K
85027 6,979 6,008 $8K
73080 1,809 1,751 $8K
64483 24 24 $8K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 1,538 1,512 $8K
58301 72 71 $8K
J0897 Injection, denosumab, 1 mg 65 63 $7K
93325 1,308 1,251 $7K
72050 394 387 $7K
73590 1,850 1,721 $7K
93270 203 202 $7K
90710 509 506 $7K
90935 Hemodialysis procedure with single evaluation by a physician 387 194 $7K
92550 71 71 $7K
0072A 184 183 $7K
86900 9,333 7,765 $7K
96376 10,050 7,184 $6K
93926 218 204 $6K
90460 Immunization administration through 18 years of age via any route, first or only component 570 562 $6K
99242 112 109 $6K
93016 610 602 $6K
92522 97 97 $6K
86140 15,512 14,080 $6K
62321 58 52 $5K
84703 17,369 16,442 $5K
86901 9,339 7,766 $5K
90685 663 658 $5K
85055 1,867 1,473 $5K
93925 122 122 $5K
99221 123 118 $5K
78227 26 26 $5K
73120 380 272 $5K
83690 31,945 29,077 $5K
85018 2,432 2,049 $5K
90791 Psychiatric diagnostic evaluation 52 52 $5K
36589 12 12 $5K
74019 833 820 $5K
95910 68 65 $5K
42820 Tonsillectomy and adenoidectomy; younger than age 12 26 26 $5K
81003 10,363 9,934 $4K
73620 532 477 $4K
87086 Culture, bacterial; quantitative colony count, urine 11,844 11,358 $4K
99310 Prolong nursin fac eval 15m 342 238 $4K
80061 Lipid panel 1,376 1,316 $4K
76942 67 64 $4K
57454 12 12 $4K
85610 30,653 23,401 $4K
90619 231 231 $4K
83036 Hemoglobin; glycosylated (A1C) 3,689 3,597 $4K
J3489 Injection, zoledronic acid, 1 mg 189 177 $4K
0001A 109 107 $4K
99442 136 121 $4K
76999 49 48 $4K
0002A 109 106 $4K
84443 Thyroid stimulating hormone (TSH) 7,580 7,226 $4K
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 1,091 1,048 $4K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 50 50 $3K
90696 244 243 $3K
93458 13 12 $3K
90688 328 328 $3K
62270 13 12 $3K
74022 1,585 1,552 $3K
90656 933 933 $3K
99231 Subsequent hospital care, per day, straightforward or low complexity 129 79 $3K
99177 1,073 1,072 $3K
90734 266 266 $3K
73564 278 251 $3K
0054A 124 121 $3K
93990 81 76 $3K
80179 1,854 1,718 $3K
71101 1,077 1,056 $3K
72170 816 761 $3K
84702 7,090 6,403 $3K
64400 14 12 $3K
96402 416 389 $3K
99173 1,838 1,826 $3K
J9070 Cyclophosphamide, 100 mg 43 27 $3K
90700 250 250 $3K
73090 1,449 1,359 $3K
76886 26 26 $3K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 4,435 4,156 $3K
64721 13 12 $3K
70360 324 319 $3K
82962 10,547 5,076 $3K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 24,264 23,109 $3K
0004A 130 129 $3K
72082 70 70 $3K
93246 74 72 $3K
97150 Therapeutic procedure(s), group (2 or more individuals) 274 127 $3K
J1050 Injection, medroxyprogesterone acetate, 1 mg 292 290 $3K
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 12 12 $2K
99218 44 41 $2K
73660 595 578 $2K
92250 68 68 $2K
95800 26 26 $2K
84100 4,888 3,991 $2K
82565 1,961 1,836 $2K
73521 167 163 $2K
G0260 Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography 26 26 $2K
73700 27 26 $2K
82550 8,479 7,600 $2K
90461 196 195 $2K
51702 213 188 $2K
99495 125 125 $2K
82077 3,574 3,264 $2K
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg 833 738 $2K
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 1,934 1,848 $2K
93018 348 330 $2K
73100 154 133 $2K
85730 10,749 9,957 $2K
J7030 Infusion, normal saline solution , 1000 cc 35,268 27,091 $2K
J2405 Injection, ondansetron hydrochloride, per 1 mg 29,635 24,463 $2K
J2785 Injection, regadenoson, 0.1 mg 1,252 1,211 $2K
93299 245 240 $2K
85014 2,056 1,637 $2K
90837 Psychotherapy, 53 minutes with patient 21 12 $2K
96161 884 870 $2K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 3,839 3,764 $2K
72157 14 14 $1K
90672 98 97 $1K
93242 37 36 $1K
99493 16 12 $1K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 15 14 $1K
95885 38 34 $1K
J1885 Injection, ketorolac tromethamine, per 15 mg 36,022 30,992 $1K
99292 31 26 $1K
90474 112 109 $1K
73552 169 158 $1K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 12 12 $1K
96523 21 18 $1K
85652 4,570 4,024 $1K
G0379 Direct admission of patient for hospital observation care 25 25 $1K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 2,975 2,894 $1K
20526 36 24 $1K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 3,058 2,995 $1K
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries 982 967 $1K
A9585 Injection, gadobutrol, 0.1 ml 6,017 5,856 $1K
58571 13 13 $1K
59514 14 12 $1K
88304 2,337 2,304 $1K
J2790 Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) 25 25 $1K
74240 12 12 $1K
92555 13 13 $1K
86923 249 206 $1K
0051A 30 30 $1K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 22,740 19,200 $998.51
99308 Subsequent nursing facility care, per day, straightforward 197 123 $985.99
84439 2,408 2,317 $981.39
93295 100 93 $977.62
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 13,555 11,922 $969.54
87186 5,430 5,239 $955.46
90480 27 27 $947.20
85007 241 190 $939.17
0111A 24 24 $916.83
99241 32 31 $900.05
87070 3,790 3,589 $878.63
0052A 32 30 $876.80
J1756 Injection, iron sucrose, 1 mg 107 52 $846.19
88300 50 44 $826.96
J3010 Injection, fentanyl citrate, 0.1 mg 24,112 18,864 $826.79
99382 12 12 $825.08
81002 4,042 3,879 $782.65
93923 26 26 $782.47
96411 1,302 818 $773.91
J2270 Injection, morphine sulfate, up to 10 mg 10,450 8,508 $761.29
77263 14 14 $740.63
82248 321 274 $732.30
99306 Prolong nursin fac eval 15m 29 28 $724.34
77300 16 13 $721.52
93225 27 27 $715.31
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass 38 36 $704.48
99305 74 56 $697.18
29065 13 12 $690.45
97163 15 15 $683.98
Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) 90 89 $678.82
77334 19 15 $678.12
83615 909 790 $648.93
J1170 Injection, hydromorphone, up to 4 mg 14,002 10,004 $623.44
99354 12 12 $612.75
87205 2,672 2,437 $610.44
87077 4,180 4,011 $608.83
20611 13 13 $598.87
73070 173 161 $595.83
73000 63 61 $585.85
J2704 Injection, propofol, 10 mg 11,432 10,202 $564.78
94010 15 15 $533.41
J1200 Injection, diphenhydramine hcl, up to 50 mg 12,289 9,608 $520.88
87210 2,401 2,359 $520.75
30901 33 30 $509.88
A9577 Injection, gadobenate dimeglumine (multihance), per ml 770 747 $507.94
88342 915 881 $502.76
90687 65 65 $499.86
J2550 Injection, promethazine hcl, up to 50 mg 2,864 2,371 $485.77
96417 3,124 1,978 $483.62
87088 2,491 2,412 $476.38
76828 30 16 $466.81
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 1,135 1,082 $464.44
J2765 Injection, metoclopramide hcl, up to 10 mg 6,895 6,068 $425.46
82570 513 445 $420.53
86920 490 382 $402.14
99217 12 12 $393.45
V5275 Ear impression, each 15 12 $393.13
96409 41 26 $380.76
90732 171 128 $379.83
93321 30 26 $377.48
J2250 Injection, midazolam hydrochloride, per 1 mg 11,661 10,863 $373.20
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 14 14 $346.61
73565 15 15 $318.14
74220 12 12 $305.80
82150 790 766 $302.52
82803 1,534 1,356 $302.37
96380 31 31 $297.57
93288 70 65 $292.07
72220 48 48 $287.73
99153 Mod sedat endo service >5yrs 1,124 1,072 $277.93
69209 73 73 $271.00
99451 12 12 $257.52
82009 1,282 1,113 $252.80
64494 29 26 $247.27
96401 79 37 $246.79
93280 57 53 $245.43
73600 33 28 $244.37
82728 87 83 $243.59
73060 117 113 $242.09
J3480 Injection, potassium chloride, per 2 meq 2,888 1,820 $242.07
80305 1,172 1,133 $240.57
84132 586 462 $232.66
J1644 Injection, heparin sodium, per 1000 units 5,682 3,413 $216.42
92504 48 45 $208.21
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 1,554 1,489 $200.45
84156 380 330 $200.22
84550 391 348 $197.12
93289 54 50 $189.99
J1650 Injection, enoxaparin sodium, 10 mg 5,426 2,853 $181.59
36591 109 83 $178.92
J0696 Injection, ceftriaxone sodium, per 250 mg 8,302 6,460 $178.08
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 2,913 2,634 $176.78
J3475 Injection, magnesium sulfate, per 500 mg 3,196 2,119 $176.18
97022 27 12 $167.52
76000 30 27 $148.46
99401 47 46 $147.03
J2060 Injection, lorazepam, 2 mg 4,920 4,070 $144.12
J8540 Dexamethasone, oral, 0.25 mg 4,253 3,940 $140.06
97016 26 12 $137.99
87075 1,129 1,044 $124.28
77001 13 12 $112.45
C1887 Catheter, guiding (may include infusion/perfusion capability) 1,561 1,328 $111.80
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 4,930 4,801 $111.65
80069 67 38 $109.67
92582 12 12 $106.96
88312 46 44 $93.83
17003 13 12 $90.31
J0690 Injection, cefazolin sodium, 500 mg 6,322 5,227 $88.30
G0009 Administration of pneumococcal vaccine 375 312 $86.05
87045 198 194 $85.92
87324 125 122 $83.77
99406 448 430 $82.37
93297 24 24 $82.35
84450 60 50 $80.44
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 30,316 23,381 $79.80
J1815 Injection, insulin, per 5 units 4,364 1,717 $79.46
84520 78 61 $76.17
80076 41 39 $74.83
84460 77 65 $71.90
82140 181 160 $70.46
86308 805 798 $69.67
0240U 1,495 1,454 $66.00
J0694 Injection, cefoxitin sodium, 1 gm 966 553 $62.22
83540 68 66 $62.04
87807 385 379 $56.15
J0780 Injection, prochlorperazine, up to 10 mg 507 454 $55.20
83550 51 50 $54.48
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 5,623 5,476 $53.30
J0330 Injection, succinylcholine chloride, up to 20 mg 3,539 3,432 $52.40
94760 164 153 $50.70
36416 5,619 3,568 $48.00
87899 206 196 $46.04
36600 52 50 $44.80
96160 13 12 $43.26
87046 198 194 $43.01
87449 126 123 $41.97
J3360 Injection, diazepam, up to 5 mg 657 595 $40.66
J3370 Injection, vancomycin hcl, 500 mg 1,086 534 $39.30
73650 15 13 $38.90
C9113 Injection, pantoprazole sodium, per vial 1,258 694 $38.52
J0171 Injection, adrenalin, epinephrine, 0.1 mg 334 307 $38.52
J1940 Injection, furosemide, up to 20 mg 896 651 $38.52
J2370 Injection, phenylephrine hcl, up to 1 ml 2,187 1,979 $38.52
J2795 Injection, ropivacaine hydrochloride, 1 mg 2,066 854 $38.52
82330 55 46 $37.40
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 4,312 2,510 $36.58
93294 12 12 $36.21
J0360 Injection, hydralazine hcl, up to 20 mg 1,027 831 $35.48
J1790 Injection, droperidol, up to 5 mg 552 500 $34.20
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 7,900 7,496 $32.50
J7050 Infusion, normal saline solution, 250 cc 8,596 4,888 $29.16
G0008 Administration of influenza virus vaccine 1,443 1,416 $28.03
81000 277 274 $25.75
82947 77 70 $20.86
J7120 Ringers lactate infusion, up to 1000 cc 2,202 1,837 $20.69
J2175 Injection, meperidine hydrochloride, per 100 mg 1,666 1,551 $16.93
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 2,592 2,137 $16.65
80143 729 682 $14.91
83037 374 367 $14.73
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 4,302 3,566 $13.56
85046 13 12 $10.83
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 978 841 $8.98
84295 49 45 $7.24
82010 221 199 $5.40
J0744 Injection, ciprofloxacin for intravenous infusion, 200 mg 155 94 $5.10
85384 17 14 $5.02
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 2,233 1,880 $2.18
99072 3,584 3,239 $0.98
J1920 Injection, labetalol hydrochloride, 5 mg 85 75 $0.07
3078F 14,002 13,090 $0.00
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 41 41 $0.00
C1760 Closure device, vascular (implantable/insertable) 14 12 $0.00
A9541 Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries 41 39 $0.00
90662 248 245 $0.00
J0689 Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg 1,683 1,389 $0.00
J0640 Injection, leucovorin calcium, per 50 mg 915 503 $0.00
C1776 Joint device (implantable) 162 159 $0.00
91311 49 49 $0.00
J7510 Prednisolone oral, per 5 mg 163 142 $0.00
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 3,165 2,935 $0.00
91300 255 243 $0.00
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) 257 252 $0.00
C1729 Catheter, drainage 419 286 $0.00
J0688 Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg 155 140 $0.00
3077F 127 124 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 553 541 $0.00
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 385 369 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 266 234 $0.00
0353U 372 366 $0.00
A6021 Collagen dressing, sterile, size 16 sq. in. or less, each 1,288 736 $0.00
A9537 Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries 26 26 $0.00
C1788 Port, indwelling (implantable) 40 40 $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 421 400 $0.00
82272 26 26 $0.00
4004F 13 12 $0.00
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 395 120 $0.00
J2916 Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg 95 41 $0.00
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 55 53 $0.00
88112 17 17 $0.00
J1171 Injection, hydromorphone, 0.1 mg 214 159 $0.00
J9000 Injection, doxorubicin hydrochloride, 10 mg 21 12 $0.00
89051 25 25 $0.00
Q9957 Injection, perflutren lipid microspheres, per ml 26 26 $0.00
Q4133 Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure) 44 12 $0.00
Q0144 Azithromycin dihydrate, oral, capsules/powder, 1 gram 29 27 $0.00
90653 54 54 $0.00
S0028 Injection, famotidine, 20 mg 130 70 $0.00
0202U Oncology (prostate), multianalyte, gene expression profiling 14 14 $0.00
C1758 Catheter, ureteral 12 12 $0.00
77012 13 13 $0.00
J3486 Injection, ziprasidone mesylate, 10 mg 23 18 $0.00
3074F 15,863 14,880 $0.00
J1836 Injection, metronidazole, 10 mg 215 167 $0.00
3079F 492 477 $0.00
A9270 Non-covered item or service 24,566 6,426 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 1,170 1,146 $0.00
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 1,209 1,026 $0.00
H0049 Alcohol and/or drug screening 260 260 $0.00
C1769 Guide wire 4,040 3,633 $0.00
J1630 Injection, haloperidol, up to 5 mg 376 313 $0.00
C1889 Implantable/insertable device, not otherwise classified 390 355 $0.00
J7644 Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram 32 32 $0.00
C1726 Catheter, balloon dilatation, non-vascular 694 640 $0.00
C1781 Mesh (implantable) 158 148 $0.00
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 270 231 $0.00
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 164 148 $0.00
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 897 335 $0.00
J7999 Compounded drug, not otherwise classified 589 537 $0.00
J1030 Injection, methylprednisolone acetate, 40 mg 554 539 $0.00
J2470 Injection, pantoprazole sodium, 40 mg 110 61 $0.00
A4648 Tissue marker, implantable, any type, each 341 307 $0.00
J9045 Injection, carboplatin, 50 mg 502 333 $0.00
96368 548 360 $0.00
J9267 Injection, paclitaxel, 1 mg 348 153 $0.00
91307 461 428 $0.00
0352U 12 12 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 632 600 $0.00
J1010 Injection, methylprednisolone acetate, 1 mg 78 77 $0.00
J3411 Injection, thiamine hcl, 100 mg 54 25 $0.00
3075F 77 72 $0.00
J0131 Injection, acetaminophen, not otherwise specified,10 mg 93 91 $0.00
J7611 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg 16 16 $0.00
97130 102 40 $0.00
J0461 Injection, atropine sulfate, 0.01 mg 20 12 $0.00
87081 29 29 $0.00
G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting 24 24 $0.00
91305 137 135 $0.00
90694 32 31 $0.00
C2617 Stent, non-coronary, temporary, without delivery system 26 25 $0.00
81015 22 21 $0.00
S2900 Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) 14 12 $0.00
Q4131 Epifix or epicord, per square centimeter 25 12 $0.00