NPI: 1134152549 · SANTA ROSA, CA 95405 · General Acute Care Hospital · NPI assigned 07/09/2006
Authorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more
| Authorized Official | ANDERSON, DONALD (ASSISTANT SECRETARY OF ENROLLMENTS) |
| Parent Organization | ST JOSEPH HEALTH SYSTEM |
| NPI Enumeration Date | 07/09/2006 |
Other providers sharing the same authorized official: ANDERSON, DONALD
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 151,115 | $8.10M |
| 2019 | 141,646 | $6.38M |
| 2020 | 118,219 | $5.71M |
| 2021 | 129,722 | $6.06M |
| 2022 | 154,349 | $7.54M |
| 2023 | 172,621 | $8.43M |
| 2024 | 132,622 | $6.54M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 89,593 | 74,451 | $6.91M |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 55,376 | 46,885 | $4.44M |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 35,311 | 32,071 | $2.42M |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 6,375 | 6,171 | $2.18M |
| 99201 | 29,139 | 25,309 | $2.06M | |
| 70450 | Computed tomography, head or brain; without contrast material | 7,219 | 6,859 | $1.40M |
| 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 | 13,745 | 12,733 | $1.10M |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 13,086 | 11,936 | $1.09M |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 7,068 | 6,505 | $984K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 20,664 | 5,403 | $967K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 2,448 | 2,388 | $961K |
| 72125 | Computed tomography, cervical spine; without contrast material | 3,032 | 2,922 | $954K |
| 97139 | 17,115 | 4,557 | $803K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 1,919 | 1,768 | $774K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 1,137 | 1,122 | $774K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 18,252 | 16,708 | $698K |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 1,914 | 1,888 | $677K |
| 96375 | Therapeutic injection; each additional sequential IV push | 13,170 | 10,764 | $671K |
| 78815 | Positron emission tomography (PET) for limited area imaging | 240 | 231 | $611K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 5,714 | 4,547 | $602K |
| J3490 | Unclassified drugs | 94,899 | 44,724 | $580K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 3,052 | 2,994 | $567K |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 1,153 | 1,143 | $453K |
| 93975 | 1,542 | 1,528 | $439K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 2,731 | 2,618 | $435K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 11,906 | 10,123 | $431K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 2,948 | 2,914 | $425K |
| J9271 | Injection, pembrolizumab, 1 mg | 30 | 24 | $379K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 49,281 | 41,043 | $356K |
| J2704 | Injection, propofol, 10 mg | 8,981 | 8,439 | $349K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 6,343 | 5,477 | $347K |
| 97750 | 3,876 | 3,192 | $329K | |
| 80053 | Comprehensive metabolic panel | 33,224 | 29,148 | $320K |
| 96361 | Intravenous infusion, hydration; each additional hour | 8,165 | 7,001 | $311K |
| 95811 | 899 | 890 | $308K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 3,735 | 3,608 | $307K |
| 73221 | 762 | 731 | $302K | |
| 72141 | 804 | 802 | $302K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 3,020 | 2,940 | $288K |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 2,972 | 2,891 | $266K |
| 71045 | Radiologic examination, chest; single view | 15,813 | 14,787 | $261K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 2,543 | 2,512 | $259K |
| 97010 | 5,793 | 1,321 | $257K | |
| 76830 | Ultrasound, transvaginal | 2,652 | 2,587 | $253K |
| 0450 | Emergency room services | 1,157 | 1,036 | $247K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 4,986 | 2,809 | $241K |
| 71250 | 951 | 935 | $218K | |
| 71275 | Computed tomographic angiography, chest, with contrast material | 644 | 627 | $205K |
| 71046 | Radiologic examination, chest; 2 views | 7,330 | 7,169 | $201K |
| 97799 | 4,587 | 1,031 | $199K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 10,362 | 9,898 | $198K |
| 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 | 2,793 | 2,596 | $194K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 15,684 | 13,646 | $189K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3,584 | 3,358 | $184K |
| 76770 | 1,792 | 1,751 | $180K | |
| 93971 | 1,148 | 1,123 | $177K | |
| 70486 | 720 | 713 | $171K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 7,892 | 6,833 | $157K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 1,806 | 1,671 | $155K |
| 83880 | 4,657 | 4,381 | $150K | |
| G9012 | Other specified case management service not elsewhere classified | 410 | 359 | $144K |
| J0185 | Injection, aprepitant, 1 mg | 466 | 292 | $135K |
| J2505 | Injection, pegfilgrastim, 6 mg | 18 | 14 | $134K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 2,419 | 1,780 | $128K |
| 72100 | 2,778 | 2,729 | $118K | |
| 73610 | 2,954 | 2,857 | $118K | |
| 73630 | 3,236 | 3,077 | $117K | |
| 73030 | 2,938 | 2,834 | $115K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | 2,772 | 2,719 | $113K |
| Z7502 | 2,917 | 2,675 | $110K | |
| 77334 | 349 | 250 | $110K | |
| 80048 | Basic metabolic panel (calcium, ionized) | 13,714 | 12,465 | $106K |
| 90715 | 1,928 | 1,918 | $99K | |
| 73130 | 2,574 | 2,454 | $98K | |
| 93970 | 371 | 358 | $97K | |
| 87631 | 883 | 871 | $95K | |
| 73562 | 2,621 | 2,479 | $92K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 10,342 | 9,500 | $92K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 263 | 260 | $89K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 2,879 | 2,560 | $82K |
| 84484 | 9,338 | 7,605 | $81K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 1,820 | 1,774 | $80K |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 10,128 | 9,188 | $77K |
| 76536 | 966 | 944 | $74K | |
| 99152 | 1,028 | 955 | $73K | |
| 83690 | 11,764 | 10,768 | $72K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 2,405 | 2,362 | $72K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 2,404 | 2,361 | $71K |
| 73110 | 1,807 | 1,729 | $70K | |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 281 | 234 | $70K |
| J1170 | Injection, hydromorphone, up to 4 mg | 6,130 | 4,692 | $68K |
| A9585 | Injection, gadobutrol, 0.1 ml | 1,286 | 1,211 | $68K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 6,928 | 5,197 | $66K |
| 87086 | Culture, bacterial; quantitative colony count, urine | 8,598 | 8,222 | $65K |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 7,353 | 6,967 | $64K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 6,388 | 5,562 | $62K |
| 74018 | 2,221 | 2,135 | $59K | |
| 73560 | 2,197 | 2,051 | $58K | |
| 76642 | 745 | 716 | $58K | |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 154 | 146 | $58K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 123 | 119 | $57K |
| J0690 | Injection, cefazolin sodium, 500 mg | 4,695 | 4,018 | $57K |
| 96367 | 956 | 656 | $57K | |
| 96417 | 1,014 | 599 | $56K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 616 | 418 | $55K |
| 83605 | 5,249 | 4,436 | $53K | |
| 73502 | 1,270 | 1,208 | $53K | |
| 81001 | 14,434 | 13,409 | $51K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 983 | 968 | $50K |
| 72040 | 1,385 | 1,357 | $50K | |
| 93017 | 412 | 403 | $50K | |
| J2785 | Injection, regadenoson, 0.1 mg | 205 | 200 | $50K |
| 80306 | 1,970 | 1,860 | $46K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 5,821 | 5,651 | $44K |
| 96415 | 858 | 561 | $44K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 3,788 | 3,345 | $41K |
| 87040 | 3,958 | 2,704 | $41K | |
| J2270 | Injection, morphine sulfate, up to 10 mg | 3,498 | 3,149 | $37K |
| 99070 | 2,132 | 1,877 | $37K | |
| 95816 | 498 | 498 | $36K | |
| 87070 | 4,927 | 4,789 | $36K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 1,101 | 1,077 | $36K |
| 73140 | 1,435 | 1,359 | $35K | |
| 80076 | 4,888 | 4,688 | $33K | |
| J1644 | Injection, heparin sodium, per 1000 units | 2,616 | 1,689 | $33K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 232 | 217 | $32K |
| J1756 | Injection, iron sucrose, 1 mg | 654 | 287 | $32K |
| J3480 | Injection, potassium chloride, per 2 meq | 662 | 430 | $32K |
| 87186 | 3,575 | 3,480 | $32K | |
| 87077 | 3,926 | 3,824 | $32K | |
| 70496 | 123 | 119 | $31K | |
| 76801 | 407 | 384 | $31K | |
| 84443 | Thyroid stimulating hormone (TSH) | 2,185 | 2,092 | $30K |
| 85055 | 1,220 | 947 | $28K | |
| 59025 | Fetal non-stress test | 829 | 407 | $28K |
| 76870 | 363 | 352 | $28K | |
| 70498 | 114 | 112 | $28K | |
| 10060 | 775 | 749 | $28K | |
| J0171 | Injection, adrenalin, epinephrine, 0.1 mg | 423 | 410 | $27K |
| 85610 | 6,949 | 6,441 | $25K | |
| 72170 | 814 | 795 | $25K | |
| 97164 | 267 | 254 | $24K | |
| 72110 | 360 | 352 | $23K | |
| Z7500 | 639 | 600 | $22K | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 3,134 | 2,696 | $21K |
| 97165 | 249 | 186 | $21K | |
| Z7610 | 1,883 | 1,115 | $20K | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 2,716 | 2,508 | $20K |
| 81003 | 8,397 | 8,052 | $20K | |
| J2060 | Injection, lorazepam, 2 mg | 2,624 | 2,300 | $20K |
| 73080 | 462 | 433 | $19K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 355 | 340 | $18K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 231 | 208 | $18K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 734 | 706 | $18K |
| 77336 | 162 | 74 | $18K | |
| 12001 | 616 | 613 | $17K | |
| 81025 | 4,865 | 4,704 | $17K | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 861 | 803 | $16K |
| 77300 | 71 | 66 | $16K | |
| 73090 | 486 | 438 | $15K | |
| 82962 | 5,030 | 4,102 | $15K | |
| 73590 | 480 | 434 | $15K | |
| J1815 | Injection, insulin, per 5 units | 473 | 371 | $15K |
| 83735 | 2,380 | 1,945 | $14K | |
| 93976 | 50 | 50 | $14K | |
| G0202 | Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed | 76 | 53 | $14K |
| 85730 | 2,348 | 2,191 | $13K | |
| 86901 | 3,885 | 3,672 | $13K | |
| J2370 | Injection, phenylephrine hcl, up to 1 ml | 438 | 412 | $13K |
| 86900 | 3,865 | 3,653 | $13K | |
| 83615 | 1,832 | 1,519 | $12K | |
| 84145 | 651 | 603 | $12K | |
| 77080 | 242 | 236 | $11K | |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 1,836 | 1,090 | $11K |
| 87075 | 1,286 | 1,235 | $11K | |
| 86850 | 3,215 | 3,065 | $10K | |
| 77066 | Tomosynthesis, mammo | 65 | 62 | $10K |
| 80047 | 836 | 824 | $10K | |
| S0020 | Injection, bupivicaine hydrochloride, 30 ml | 569 | 555 | $10K |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 275 | 267 | $9K |
| 85027 | 1,663 | 1,422 | $8K | |
| 85379 | 887 | 863 | $8K | |
| 73564 | 191 | 185 | $7K | |
| 72197 | 17 | 15 | $7K | |
| 99153 | Mod sedat endo service >5yrs | 409 | 382 | $7K |
| 87205 | 1,975 | 1,871 | $7K | |
| J3475 | Injection, magnesium sulfate, per 500 mg | 691 | 466 | $7K |
| 87634 | 127 | 120 | $6K | |
| 81002 | 3,132 | 2,866 | $6K | |
| G0400 | Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels | 106 | 106 | $6K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 195 | 195 | $6K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 635 | 403 | $6K |
| J0640 | Injection, leucovorin calcium, per 50 mg | 37 | 12 | $6K |
| 12011 | 135 | 135 | $6K | |
| 71271 | 44 | 44 | $6K | |
| J3370 | Injection, vancomycin hcl, 500 mg | 437 | 336 | $6K |
| 86140 | 1,100 | 1,014 | $5K | |
| 96368 | 189 | 139 | $5K | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 173 | 114 | $5K |
| 76999 | 42 | 42 | $5K | |
| 74183 | 12 | 12 | $5K | |
| 99199 | Unlisted special service, procedure or report | 120 | 107 | $5K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 135 | 135 | $5K |
| 88342 | 408 | 385 | $5K | |
| 12002 | 174 | 173 | $5K | |
| 29125 | 375 | 364 | $5K | |
| 99284 | Emergency department visit for the evaluation and management, high severity | 16 | 15 | $5K |
| 70491 | 13 | 12 | $5K | |
| 82077 | 326 | 299 | $5K | |
| 86141 | 436 | 418 | $5K | |
| 77081 | 177 | 172 | $5K | |
| 73700 | 15 | 14 | $4K | |
| 76827 | 57 | 56 | $4K | |
| 88304 | 493 | 483 | $4K | |
| 96416 | 44 | 24 | $4K | |
| 96523 | 288 | 213 | $4K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 65 | 59 | $4K |
| 83036 | Hemoglobin; glycosylated (A1C) | 562 | 531 | $4K |
| 72146 | 12 | 12 | $3K | |
| J9190 | Injection, fluorouracil, 500 mg | 52 | 25 | $3K |
| 87081 | 668 | 644 | $3K | |
| 87147 | 618 | 616 | $3K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 25 | 25 | $3K |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 464 | 393 | $3K |
| 72070 | 67 | 63 | $3K | |
| J7030 | Infusion, normal saline solution , 1000 cc | 347 | 293 | $3K |
| 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) | 30 | 26 | $3K |
| 93880 | 13 | 13 | $2K | |
| 82248 | 610 | 559 | $2K | |
| 29823 | 12 | 12 | $2K | |
| 96402 | 117 | 107 | $2K | |
| Q0144 | Azithromycin dihydrate, oral, capsules/powder, 1 gram | 61 | 61 | $2K |
| 85652 | 627 | 601 | $2K | |
| 82803 | 185 | 166 | $2K | |
| 73070 | 66 | 63 | $2K | |
| 80143 | 117 | 107 | $2K | |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 79 | 78 | $2K |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 158 | 144 | $2K |
| 82728 | 134 | 131 | $2K | |
| 73620 | 69 | 63 | $2K | |
| 80061 | Lipid panel | 216 | 203 | $2K |
| S0077 | Injection, clindamycin phosphate, 300 mg | 97 | 93 | $2K |
| 80179 | 115 | 106 | $2K | |
| 85018 | 773 | 682 | $2K | |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 71 | 57 | $2K |
| J7050 | Infusion, normal saline solution, 250 cc | 395 | 179 | $2K |
| 82805 | 75 | 71 | $2K | |
| 29515 | 105 | 103 | $1K | |
| 0270 | 34 | 12 | $1K | |
| 82550 | 207 | 185 | $1K | |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | 43 | 42 | $1K |
| 96411 | 35 | 24 | $1K | |
| 84702 | 123 | 108 | $1K | |
| J3489 | Injection, zoledronic acid, 1 mg | 12 | 12 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 50 | 44 | $1K |
| 0456 | 39 | 38 | $1K | |
| 73600 | 39 | 38 | $1K | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 16 | 12 | $996.18 |
| 84439 | 159 | 147 | $972.84 | |
| J0360 | Injection, hydralazine hcl, up to 20 mg | 69 | 62 | $956.91 |
| 82140 | 72 | 63 | $940.88 | |
| 73660 | 39 | 37 | $910.50 | |
| 73060 | 28 | 25 | $895.44 | |
| 72081 | 25 | 25 | $882.74 | |
| 84466 | 54 | 53 | $867.19 | |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 58 | 37 | $826.46 |
| 94729 | 12 | 12 | $820.68 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | 108 | 100 | $770.72 |
| 94726 | 12 | 12 | $752.16 | |
| 76882 | 47 | 41 | $686.80 | |
| 72050 | 14 | 14 | $643.80 | |
| 86923 | 14 | 12 | $616.00 | |
| 29130 | 41 | 41 | $615.34 | |
| 71010 | 30 | 27 | $602.31 | |
| 29505 | 39 | 39 | $548.21 | |
| 85014 | 202 | 200 | $530.88 | |
| 73521 | 13 | 13 | $508.08 | |
| 83540 | 67 | 66 | $507.73 | |
| 73120 | 18 | 16 | $464.40 | |
| 88142 | 51 | 51 | $438.25 | |
| 84132 | 108 | 93 | $436.86 | |
| 84100 | 133 | 104 | $424.96 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 81 | 77 | $367.47 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 80 | 75 | $352.34 |
| 73565 | 14 | 14 | $351.00 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 55 | 54 | $328.61 |
| 73100 | 13 | 13 | $324.36 | |
| J1953 | Injection, levetiracetam, 10 mg | 19 | 14 | $302.66 |
| 84703 | 56 | 54 | $297.25 | |
| S0164 | Injection, pantoprazole sodium, 40 mg | 23 | 14 | $245.68 |
| J1171 | Injection, hydromorphone, 0.1 mg | 31 | 28 | $223.25 |
| 82378 | 16 | 14 | $194.08 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | 30 | 16 | $188.21 |
| 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 | 638 | 471 | $175.38 |
| J1940 | Injection, furosemide, up to 20 mg | 29 | 24 | $163.44 |
| 82746 | 12 | 12 | $128.13 | |
| T1999 | Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" | 16 | 12 | $114.13 |
| J8540 | Dexamethasone, oral, 0.25 mg | 1,100 | 616 | $110.89 |
| 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 | 1,480 | 966 | $107.90 |
| 87210 | 12 | 12 | $81.00 | |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 14 | 14 | $69.02 |
| 86308 | 13 | 12 | $46.67 | |
| 88300 | 17 | 16 | $28.39 | |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 649 | 585 | $23.45 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 72 | 70 | $5.50 |