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

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

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