Performance Measurement in the Hospital Outpatient Setting. Most Frequent Used Drugs and Biologicals in the Hospital Outpatient Setting and Emergency Department

02/01/2008

Table 3.6 shows the 50 most frequent, separately billed drugs and biologicals associated with services in the HOPS and ED.28 In both the HOPS and ED, imaging contrast material, blood products and medications associated with cancer chemotherapy are among the most frequently used. In the ED, several thrombolytic agents are also frequently used. These findings derive from the data provided by CMS and have not been aggregated by drug or drug class. Additional analyses of drugs and biologicals would inform opportunities for measure development.

Table 3.7. Top 50 Separately Billed Drugs/Biologicals in the HOPS and ED, Medicare 2005
HOPS
Emergency Department
APC APC definition Volume APC APC definition Volume
4646 Contrast 300-399 MGs iodine 951,639 768 Ondansetron hcl injection 180,380
733 Non esrd epoetin alpha inj 610,121 4646 Contrast 300-399 MGs iodine 124,136
768 Ondansetron hcl injection 486,806 750 Dolasetron mesylate 27,611
1600 Tc99m sestamibi 359,301 1600 Tc99m sestamibi 26,186
954 RBC leukocytes reduced 309,368 954 RBC leukocytes reduced 21,140
734 Darbepoetin alfa, non esrd 303,060 705 Tc99m tetrofosmin 17,722
9027 Supp- paramagnetic contr mat 209,894 9223 Inj adenosine, tx dx 17,236
705 Tc99m tetrofosmin 203,824 7028 Fosphenytoin, 50 mg 10,410
1775 FDG, per dose (4-40 mCi/ml) 146,799 1603 TL201 thallium 10,313
750 Dolasetron mesylate 137,086 4644 Contrast 100-199 MGs iodine 9,483
4645 Contrast 200-299 MGs iodine 130,186 733 Non esrd epoetin alpha inj 9,161
764 Granisetron HCl injection 125,375 764 Granisetron HCl injection 8,755
1603 TL201 thallium 121,426 9042 Glucagon hydrochloride/1 MG 8,395
9223 Inj adenosine, tx dx 119,916 4645 Contrast 200-299 MGs iodine 7,956
9115 Zoledronic acid 104,174 9027 Supp- paramagnetic contr mat 7,716
9114 Nesiritide 89,536 959 Red blood cells unit 6,989
811 Carboplatin injection 87,670 1670 Tetanus immune globulin inj 6,938
4644 Contrast 100-199 MGs iodine 83,853 9508 Plasma 1 donor frz w/in 8 hr 5,790
863 Paclitaxel injection 82,377 3033 Technetium tc-99m pentetate 5,539
959 Red blood cells unit 81,503 1607 Eptifibatide injection 3,564
828 Gemcitabine HCl 72,729 379 Injection adenosine 6 MG 3,289
728 Filgrastim 300 mcg injection 67,612 935 Clonidine hydrochloride 3,265
9119 Injection, pegfilgrastim 6mg 67,361 9139 Rabies vaccine, im 3,173
7043 Infliximab injection 65,192 917 Adenosine injection 3,086
765 Granisetron HCl 1 mg oral 64,247 734 Darbepoetin alfa, non esrd 2,081

 

Table 3.7. Top 50 Separately Billed Drugs/Biologicals in the HOPS and ED, Medicare 2005 (continued)

HOPS

Emergency Department

APC

APC definition

Volume

APC

APC definition

Volume

4646 Contrast 300-399 MGs iodine

951,639

0768 Ondansetron hcl injection

180,380

0733 Non esrd epoetin alpha inj

610,121

4646 Contrast 300-399 MGs iodine

124,136

0768 Ondansetron hcl injection

486,806

0750 Dolasetron mesylate

27,611

1600 Tc99m sestamibi

359,301

1600 Tc99m sestamibi

26,186

0954 RBC leukocytes reduced

309,368

0954 RBC leukocytes reduced

21,140

0734 Darbepoetin alfa, non esrd

303,060

0705 Tc99m tetrofosmin

17,722

9027 Supp- paramagnetic contr mat

209,894

9223 Inj adenosine, tx dx

17,236

0705 Tc99m tetrofosmin

203,824

7028 Fosphenytoin, 50 mg

10,410

1775 FDG, per dose (4-40 mCi/ml)

146,799

1603 TL201 thallium

10,313

0750 Dolasetron mesylate

137,086

4644 Contrast 100-199 MGs iodine

9,483

4645 Contrast 200-299 MGs iodine

130,186

0733 Non esrd epoetin alpha inj

9,161

0764 Granisetron HCl injection

125,375

0764 Granisetron HCl injection

8,755

1603 TL201 thallium

121,426

9042 Glucagon hydrochloride/1 MG

8,395

9223 Inj adenosine, tx dx

119,916

4645 Contrast 200-299 MGs iodine

7,956

9115 Zoledronic acid

104,174

9027 Supp- paramagnetic contr mat

7,716

9114 Nesiritide

89,536

0959 Red blood cells unit

6,989

0811 Carboplatin injection

87,670

1670 Tetanus immune globulin inj

6,938

4644 Contrast 100-199 MGs iodine

83,853

9508 Plasma 1 donor frz w/in 8 hr

5,790

0863 Paclitaxel injection

82,377

3033 Technetium tc-99m pentetate

5,539

0959 Red blood cells unit

81,503

1607 Eptifibatide injection

3,564

0828 Gemcitabine HCl

72,729

0379 Injection adenosine 6 MG

3,289

0728 Filgrastim 300 mcg injection

67,612

0935 Clonidine hydrochloride

3,265

9119 Injection, pegfilgrastim 6mg

67,361

9139 Rabies vaccine, im

3,173

7043 Infliximab injection

65,192

0917 Adenosine injection

3,086

0765 Granisetron HCl 1 mg oral

64,247

0734 Darbepoetin alfa, non esrd

2,081

 

Table 3.7. Top 50 Separately Billed Drugs/Biologicals in the HOPS and ED, Medicare 2005 (continued)

HOPS

Emergency Department

APC

APC definition

Volume

APC

APC definition

Volume

7049 Filgrastim 480 mcg injection

60,354

9112 Inj perflutren lip micros,ml

1,926

0849 Rituximab cancer treatment

59,390

7048 Alteplase recombinant

1,762

9210 Palonosetron HCl

55,903

3030 Sumatriptan succinate / 6 MG

1,695

0823

Docetaxel

54,261

0769

Ondansetron HCl 8mg oral

1,571

0869

IVIG lyophil 1g

44,227

9501

Platelet pheres leukoreduced

1,557

9042

Glucagon hydrochloride/1 MG

42,442

9114

Nesiritide

1,459

9046

Iron sucrose injection

40,848

7049

Filgrastim 480 mcg injection

1,424

0769

Ondansetron HCl 8mg oral

38,847

0728

Filgrastim 300 mcg injection

1,202

9501

Platelet pheres leukoreduced

38,257

9015

Mycophenolate mofetil oral

1,172

0730

Pamidronate disodium /30 MG

36,150

0891

Tacrolimus oral per 1 MG

1,167

9148

I123 iodide cap, dx

35,333

9002

Tenecteplase injection

1,112

7316

Sodium hyaluronate injection

35,074

9202

Inj octafluoropropane mic,ml

1,001

0969

RBC leukoreduced irradiated

34,997

9005

Reteplase injection

965

9214

Bevacizumab injection

33,170

0965

Albumin (human), 25%, 50ml

891

1613

Trastuzumab

32,886

9133

Rabies ig, im/sc

883

0830

Irinotecan injection

32,192

0969

RBC leukoreduced irradiated

877

0917

Adenosine injection

31,416

9124

Daptomycin injection

683

9205

Oxaliplatin

30,843

9026

High dose contrast MRI

664

9124

Daptomycin injection

29,519

9044

Ibutilide fumarate injection

639

0871

IVIG non-lyophil 1g

28,313

0811

Carboplatin injection

558

3048

Doxorubic hcl 10 MG vl chemo

26,629

9155

Technetium tc99mlabeledrbcs

528

7000

Amifostine

25,682

0888

Cyclosporine oral 100 mg

505

9218

Injection, Azacitidine

25,349

9025

Rubidium-Rb-82

485

1622

Technetium tc99m mertiatide

24,340

9046

Iron sucrose injection

474

9207

Bortezomib injection

24,216

1019

Plate pheres leukoredu irrad

473

 

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