NPI: 1306842521 · HARLAN, KY 40831 · General Acute Care Hospital · NPI assigned 06/22/2005
Authorized official HARRIS, HOLLIE controls 20+ related entities in our dataset. Read more
| Authorized Official | HARRIS, HOLLIE (PRESIDENT AND CEO) |
| NPI Enumeration Date | 06/22/2005 |
Other providers sharing the same authorized official: HARRIS, HOLLIE
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 174,358 | $9.65M |
| 2019 | 140,440 | $7.84M |
| 2020 | 132,826 | $6.32M |
| 2021 | 142,902 | $6.83M |
| 2022 | 139,734 | $7.78M |
| 2023 | 128,647 | $8.23M |
| 2024 | 109,287 | $8.56M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99284 | Emergency department visit for the evaluation and management, high severity | 24,198 | 19,890 | $10.19M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 10,456 | 7,290 | $4.93M |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 7,176 | 6,029 | $4.74M |
| G0378 | Hospital observation service, per hour | 12,369 | 7,136 | $4.66M |
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 18,651 | 15,598 | $1.89M |
| 70450 | Computed tomography, head or brain; without contrast material | 4,939 | 4,107 | $1.37M |
| 80053 | Comprehensive metabolic panel | 52,773 | 38,315 | $1.22M |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 1,309 | 1,079 | $1.05M |
| 96361 | Intravenous infusion, hydration; each additional hour | 13,670 | 6,182 | $1.04M |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 68,994 | 51,225 | $853K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 15,289 | 3,771 | $830K |
| 71045 | Radiologic examination, chest; single view | 16,355 | 12,585 | $740K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 1,741 | 1,036 | $734K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 18,417 | 13,101 | $701K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 1,248 | 814 | $670K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1,888 | 1,642 | $637K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 11,362 | 6,143 | $623K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 8,357 | 4,190 | $600K |
| 83735 | 8,928 | 7,642 | $598K | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 10,671 | 3,781 | $583K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 14,022 | 11,951 | $535K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 7,587 | 2,447 | $534K |
| 36415 | Collection of venous blood by venipuncture | 153,206 | 64,913 | $486K |
| 84443 | Thyroid stimulating hormone (TSH) | 16,103 | 15,113 | $461K |
| 80061 | Lipid panel | 13,362 | 12,434 | $459K |
| 80048 | Basic metabolic panel (calcium, ionized) | 23,140 | 17,051 | $447K |
| 71250 | 1,343 | 1,104 | $414K | |
| 84484 | 13,243 | 9,567 | $408K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 10,954 | 6,531 | $400K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 17,545 | 11,194 | $384K |
| 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 | 9,951 | 7,016 | $365K |
| 87040 | 8,160 | 6,135 | $363K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 4,893 | 4,287 | $349K |
| 72125 | Computed tomography, cervical spine; without contrast material | 829 | 747 | $337K |
| 71046 | Radiologic examination, chest; 2 views | 6,100 | 5,167 | $326K |
| 81025 | 11,173 | 9,206 | $317K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 6,331 | 5,707 | $299K |
| 82607 | 8,143 | 7,661 | $296K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 5,471 | 1,708 | $296K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 4,765 | 2,796 | $267K |
| 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 | 8,964 | 8,075 | $265K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 6,936 | 6,534 | $263K |
| 72131 | 643 | 564 | $259K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 3,072 | 2,250 | $231K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 3,450 | 1,953 | $226K |
| 81001 | 23,453 | 19,900 | $207K | |
| 74022 | 1,595 | 1,443 | $203K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1,942 | 1,672 | $202K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 1,625 | 1,509 | $202K |
| 96375 | Therapeutic injection; each additional sequential IV push | 8,290 | 6,031 | $194K |
| 96376 | 5,332 | 2,846 | $184K | |
| 83690 | 6,973 | 5,933 | $177K | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 5,806 | 1,323 | $176K |
| 87631 | 2,188 | 2,062 | $172K | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 299 | 272 | $158K |
| 87086 | Culture, bacterial; quantitative colony count, urine | 8,360 | 7,052 | $150K |
| 83036 | Hemoglobin; glycosylated (A1C) | 11,709 | 11,128 | $146K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 3,183 | 2,902 | $144K |
| 82150 | 3,398 | 2,856 | $138K | |
| 97597 | 2,893 | 1,137 | $130K | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 17,237 | 12,436 | $129K |
| 80076 | 4,315 | 3,758 | $123K | |
| 73630 | 1,804 | 1,644 | $121K | |
| 82728 | 3,025 | 2,796 | $120K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 4,318 | 1,950 | $120K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 6,046 | 5,602 | $117K |
| 72100 | 1,712 | 1,479 | $112K | |
| 74018 | 1,828 | 1,414 | $111K | |
| 87186 | 3,806 | 3,272 | $102K | |
| 73030 | 1,837 | 1,532 | $100K | |
| 85730 | 3,085 | 2,628 | $97K | |
| 73610 | 1,573 | 1,351 | $96K | |
| 96367 | 2,892 | 1,594 | $89K | |
| 76830 | Ultrasound, transvaginal | 421 | 396 | $87K |
| 70486 | 270 | 235 | $86K | |
| G0379 | Direct admission of patient for hospital observation care | 1,824 | 1,285 | $85K |
| 83880 | 2,432 | 2,076 | $82K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 1,844 | 1,790 | $80K |
| 83970 | 1,250 | 1,166 | $80K | |
| 82570 | 2,666 | 2,371 | $80K | |
| 84439 | 2,620 | 2,486 | $79K | |
| 93041 | 4,176 | 3,547 | $77K | |
| 85610 | 5,300 | 4,169 | $75K | |
| 87070 | 3,360 | 2,598 | $74K | |
| 80074 | 1,285 | 1,165 | $74K | |
| 82550 | 5,291 | 4,244 | $72K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 386 | 310 | $66K |
| 83540 | 2,928 | 2,725 | $62K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 2,673 | 2,325 | $61K |
| 87077 | 4,390 | 3,178 | $60K | |
| 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 | 7,395 | 6,508 | $60K |
| 82553 | 2,424 | 1,706 | $59K | |
| 73130 | 958 | 868 | $59K | |
| 83605 | 5,234 | 4,196 | $55K | |
| 86140 | 3,439 | 2,752 | $54K | |
| 82803 | 1,714 | 1,376 | $51K | |
| 80069 | 2,654 | 1,605 | $51K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 228 | 143 | $50K |
| 97162 | 1,058 | 910 | $49K | |
| 84702 | 1,424 | 1,197 | $45K | |
| 86038 | 1,283 | 1,193 | $45K | |
| 73110 | 635 | 559 | $42K | |
| 73560 | 759 | 648 | $41K | |
| 85652 | 3,670 | 3,039 | $40K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,048 | 1,639 | $40K |
| 71271 | 91 | 83 | $38K | |
| 96368 | 747 | 520 | $38K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 1,728 | 1,614 | $38K |
| 73562 | 493 | 462 | $37K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 192 | 92 | $35K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 161 | 146 | $33K |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 963 | 885 | $31K |
| 84156 | 2,184 | 1,958 | $31K | |
| 85027 | 2,926 | 2,762 | $31K | |
| 76536 | 196 | 184 | $31K | |
| 87076 | 2,948 | 1,800 | $30K | |
| 97161 | 832 | 625 | $28K | |
| 72110 | 330 | 274 | $28K | |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 270 | 215 | $25K |
| 84703 | 1,171 | 1,094 | $25K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 1,203 | 1,144 | $24K |
| 93017 | 148 | 135 | $24K | |
| 87522 | Neg quan hep c or qual rna | 769 | 695 | $23K |
| 87507 | 103 | 94 | $23K | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 2,565 | 1,461 | $23K |
| 83550 | 1,193 | 1,106 | $23K | |
| 93971 | 183 | 170 | $23K | |
| 84550 | 1,876 | 1,689 | $22K | |
| 83655 | 828 | 791 | $22K | |
| 73090 | 380 | 327 | $22K | |
| 73590 | 347 | 313 | $21K | |
| 97014 | 439 | 125 | $21K | |
| 94060 | 372 | 208 | $19K | |
| 78454 | 99 | 50 | $19K | |
| 73502 | 375 | 335 | $18K | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | 1,124 | 1,060 | $18K |
| 72040 | 271 | 233 | $17K | |
| 47562 | 12 | 12 | $17K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1,200 | 1,133 | $17K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 550 | 494 | $16K |
| 82043 | 1,322 | 1,196 | $16K | |
| 86431 | 646 | 621 | $16K | |
| 36600 | 1,699 | 1,360 | $15K | |
| 87634 | 413 | 390 | $15K | |
| 86850 | 1,036 | 877 | $14K | |
| 73620 | 240 | 213 | $14K | |
| 81003 | 1,801 | 1,626 | $14K | |
| 84153 | 553 | 511 | $14K | |
| 86901 | 1,252 | 1,058 | $14K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1,247 | 1,119 | $12K |
| J1956 | Injection, levofloxacin, 250 mg | 1,760 | 1,001 | $12K |
| 82542 | 163 | 154 | $12K | |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 115 | 50 | $12K |
| 86200 | 632 | 594 | $11K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 6,648 | 4,804 | $11K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 42 | 26 | $11K |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 119 | 13 | $11K |
| 86900 | 1,267 | 1,060 | $11K | |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 286 | 258 | $11K |
| 90715 | 331 | 315 | $11K | |
| 12001 | 137 | 132 | $10K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 37 | 17 | $10K |
| 88304 | 501 | 453 | $9K | |
| 82103 | 263 | 178 | $9K | |
| 76000 | 153 | 110 | $9K | |
| 0012A | 679 | 662 | $9K | |
| 84100 | 754 | 639 | $9K | |
| 76641 | 68 | 66 | $9K | |
| 76770 | 101 | 79 | $8K | |
| 81002 | 1,145 | 980 | $8K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 13 | 12 | $8K |
| 87590 | 491 | 460 | $8K | |
| 80171 | 138 | 128 | $8K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 1,951 | 1,308 | $8K |
| 85378 | 613 | 562 | $8K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 18 | 12 | $7K |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 122 | 63 | $7K |
| 94618 | 136 | 123 | $7K | |
| J2270 | Injection, morphine sulfate, up to 10 mg | 3,070 | 2,000 | $7K |
| 0097U | 107 | 82 | $6K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 43 | 42 | $6K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 58 | 56 | $6K |
| 72050 | 65 | 57 | $5K | |
| 0011A | 698 | 672 | $5K | |
| J0690 | Injection, cefazolin sodium, 500 mg | 792 | 618 | $5K |
| 93226 | 41 | 38 | $5K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 978 | 910 | $5K |
| 73120 | 92 | 83 | $4K | |
| 73600 | 84 | 72 | $4K | |
| 87480 | 388 | 327 | $4K | |
| J3490 | Unclassified drugs | 942 | 748 | $4K |
| 78227 | 13 | 12 | $4K | |
| 93225 | 66 | 53 | $4K | |
| 88142 | 152 | 149 | $4K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 1,456 | 1,261 | $4K |
| 94729 | 125 | 106 | $4K | |
| 73564 | 56 | 53 | $4K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 3,103 | 2,354 | $3K |
| 94727 | 126 | 107 | $3K | |
| 87510 | 301 | 292 | $3K | |
| 97035 | 156 | 44 | $3K | |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 306 | 181 | $3K |
| 0100U | 60 | 59 | $3K | |
| 84481 | 53 | 50 | $3K | |
| 80081 | 12 | 12 | $3K | |
| 97166 | 77 | 54 | $3K | |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 26 | 25 | $3K |
| 92523 | 31 | 30 | $3K | |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 218 | 205 | $3K |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 320 | 137 | $3K |
| 72128 | 14 | 12 | $3K | |
| 90714 | 121 | 118 | $3K | |
| 86803 | 99 | 94 | $3K | |
| 73100 | 48 | 41 | $3K | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 1,354 | 1,148 | $2K |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring | 19 | 14 | $2K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 32 | 12 | $2K |
| 83001 | 45 | 43 | $2K | |
| 87660 | 301 | 292 | $2K | |
| 12002 | 28 | 26 | $2K | |
| 84436 | 67 | 67 | $2K | |
| 95831 | 95 | 30 | $2K | |
| 73140 | 25 | 25 | $2K | |
| 73070 | 34 | 29 | $2K | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 1,069 | 907 | $2K |
| 84145 | 32 | 30 | $2K | |
| 36430 | 15 | 12 | $2K | |
| 82140 | 68 | 51 | $1K | |
| 99499 | 46 | 44 | $1K | |
| J2805 | Injection, sincalide, 5 micrograms | 13 | 12 | $1K |
| G0476 | Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test | 52 | 45 | $1K |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 244 | 64 | $1K |
| J3370 | Injection, vancomycin hcl, 500 mg | 46 | 12 | $1K |
| 36416 | 384 | 342 | $1K | |
| 84146 | 26 | 25 | $1K | |
| 86787 | 18 | 14 | $1K | |
| 82746 | 30 | 26 | $1K | |
| 59025 | Fetal non-stress test | 20 | 13 | $998.93 |
| 82565 | 84 | 70 | $996.46 | |
| 84134 | 48 | 40 | $983.82 | |
| 74019 | 14 | 12 | $974.50 | |
| M0239 | Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring | 13 | 12 | $933.72 |
| 82652 | 34 | 32 | $901.93 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | 52 | 44 | $884.51 |
| 87807 | 175 | 160 | $864.02 | |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 71 | 43 | $855.91 |
| A9537 | Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries | 25 | 24 | $779.24 |
| 87075 | 32 | 24 | $763.16 | |
| 83002 | 19 | 17 | $739.07 | |
| 85007 | 70 | 66 | $734.45 | |
| 87338 | 14 | 14 | $701.96 | |
| 80143 | 77 | 70 | $675.09 | |
| 0064A | 102 | 86 | $663.76 | |
| 86706 | 28 | 24 | $622.79 | |
| J2175 | Injection, meperidine hydrochloride, per 100 mg | 152 | 122 | $620.70 |
| Q9969 | Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose | 277 | 265 | $589.58 |
| 84112 | 19 | 16 | $582.33 | |
| 76775 | 14 | 12 | $579.03 | |
| 80164 | 39 | 39 | $561.42 | |
| 94761 | 25 | 12 | $557.55 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 422 | 268 | $554.43 |
| J1650 | Injection, enoxaparin sodium, 10 mg | 14 | 12 | $546.17 |
| 82105 | 13 | 12 | $540.26 | |
| 80185 | 23 | 12 | $536.20 | |
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 18 | 12 | $532.74 |
| 82274 | 57 | 56 | $513.37 | |
| 87340 | 24 | 24 | $504.64 | |
| 82104 | 70 | 67 | $460.45 | |
| 83516 | 15 | 13 | $447.92 | |
| 82670 | 14 | 12 | $402.60 | |
| 84520 | 26 | 24 | $400.92 | |
| 86703 | 31 | 25 | $374.05 | |
| 86804 | 13 | 12 | $364.76 | |
| 84403 | 25 | 25 | $359.36 | |
| J1170 | Injection, hydromorphone, up to 4 mg | 124 | 109 | $312.62 |
| 86592 | 28 | 28 | $306.94 | |
| 87205 | 29 | 29 | $304.61 | |
| 0002A | 17 | 17 | $294.20 | |
| 85379 | 14 | 13 | $277.54 | |
| 84270 | 12 | 12 | $276.95 | |
| J0736 | Injection, clindamycin phosphate, 300 mg | 29 | 15 | $249.05 |
| J2470 | Injection, pantoprazole sodium, 40 mg | 75 | 48 | $239.82 |
| J2550 | Injection, promethazine hcl, up to 50 mg | 325 | 242 | $207.10 |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 27 | 24 | $190.39 |
| 0001A | 13 | 13 | $185.64 | |
| 82947 | 17 | 12 | $173.58 | |
| 84402 | 12 | 12 | $162.78 | |
| 85018 | 13 | 13 | $144.64 | |
| 85014 | 12 | 12 | $139.28 | |
| J7510 | Prednisolone oral, per 5 mg | 93 | 78 | $136.53 |
| 84560 | 16 | 12 | $129.50 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 79 | 73 | $108.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 119 | 101 | $104.10 |
| 86430 | 15 | 14 | $95.20 | |
| A9270 | Non-covered item or service | 1,571 | 227 | $88.20 |
| J3475 | Injection, magnesium sulfate, per 500 mg | 16 | 13 | $50.63 |
| J1644 | Injection, heparin sodium, per 1000 units | 40 | 12 | $29.52 |
| J2060 | Injection, lorazepam, 2 mg | 15 | 13 | $19.09 |
| Q0244 | Injection, casirivimab and imdevimab, 1200 mg | 41 | 41 | $0.07 |
| Q0245 | Injection, bamlanivimab and etesevimab, 2100 mg | 19 | 14 | $0.01 |
| Q0239 | Injection, bamlanivimab-xxxx, 700 mg | 13 | 12 | $0.00 |