NPI: 1366404428 · RICHMOND, VA 23223 · General Acute Care Hospital · NPI assigned 04/04/2006
Authorized official RALSTON, KIMBERLY controls 20+ related entities in our dataset. Read more
| Authorized Official | RALSTON, KIMBERLY (SYSTEM DIRECTOR) |
| NPI Enumeration Date | 04/04/2006 |
Other providers sharing the same authorized official: RALSTON, KIMBERLY
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 123,494 | $4.19M |
| 2019 | 167,179 | $6.88M |
| 2020 | 147,766 | $6.39M |
| 2021 | 177,883 | $7.79M |
| 2022 | 187,315 | $9.03M |
| 2023 | 207,440 | $11.64M |
| 2024 | 171,605 | $11.29M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 85,012 | 73,159 | $13.87M |
| 99284 | Emergency department visit for the evaluation and management, high severity | 44,747 | 38,409 | $7.77M |
| J9271 | Injection, pembrolizumab, 1 mg | 1,149 | 761 | $4.57M |
| 96361 | Intravenous infusion, hydration; each additional hour | 12,318 | 9,394 | $3.95M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 16,651 | 14,416 | $3.10M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 17,371 | 15,238 | $2.41M |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 14,678 | 9,026 | $2.00M |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 13,914 | 8,034 | $1.77M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 13,618 | 10,313 | $1.31M |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 5,260 | 3,324 | $1.24M |
| 70450 | Computed tomography, head or brain; without contrast material | 5,871 | 5,191 | $1.18M |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 4,794 | 4,283 | $1.13M |
| 96415 | 4,090 | 2,769 | $983K | |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 775 | 547 | $973K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 24,098 | 5,131 | $750K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 4,708 | 3,124 | $676K |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 491 | 306 | $664K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 23,728 | 3,308 | $517K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1,711 | 1,349 | $500K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 2,472 | 2,181 | $492K |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | 440 | 343 | $476K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 8,865 | 6,038 | $417K |
| 90791 | Psychiatric diagnostic evaluation | 2,137 | 1,827 | $347K |
| 71275 | Computed tomographic angiography, chest, with contrast material | 1,370 | 1,214 | $339K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 7,942 | 6,843 | $314K |
| 96367 | 3,583 | 2,331 | $297K | |
| G0378 | Hospital observation service, per hour | 1,370 | 791 | $264K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 8,814 | 1,534 | $256K |
| J2469 | Injection, palonosetron hcl, 25 mcg | 4,069 | 2,292 | $226K |
| J0897 | Injection, denosumab, 1 mg | 878 | 683 | $224K |
| J1453 | Injection, fosaprepitant, 1 mg | 2,025 | 1,236 | $207K |
| 96416 | 1,031 | 569 | $196K | |
| 97161 | 2,280 | 2,058 | $187K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 3,947 | 3,730 | $186K |
| J2505 | Injection, pegfilgrastim, 6 mg | 104 | 65 | $171K |
| 80053 | Comprehensive metabolic panel | 47,268 | 36,627 | $164K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1,890 | 1,677 | $150K |
| 97116 | 12,186 | 2,381 | $144K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 16,253 | 14,434 | $128K |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 76 | 24 | $125K |
| 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 | 4,316 | 4,025 | $125K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 24,282 | 18,927 | $111K |
| 93971 | 1,206 | 1,072 | $104K | |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 892 | 534 | $102K |
| 96523 | 1,709 | 1,101 | $98K | |
| J3380 | Injection, vedolizumab, intravenous, 1 mg | 51 | 38 | $97K |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | 987 | 539 | $83K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 370 | 37 | $68K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 451 | 410 | $63K |
| 71046 | Radiologic examination, chest; 2 views | 7,796 | 6,972 | $61K |
| 76830 | Ultrasound, transvaginal | 664 | 608 | $61K |
| 10060 | 458 | 411 | $60K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 642 | 585 | $55K |
| G0330 | Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room | 28 | 27 | $49K |
| 10061 | 498 | 434 | $47K | |
| 72100 | 2,813 | 2,577 | $46K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 30,236 | 23,906 | $44K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 6,246 | 2,045 | $43K |
| J1756 | Injection, iron sucrose, 1 mg | 3,498 | 1,457 | $40K |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 16 | 13 | $40K |
| 73562 | 4,228 | 3,534 | $39K | |
| 12001 | 169 | 160 | $39K | |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 9,193 | 8,266 | $37K |
| 91200 | 480 | 421 | $35K | |
| 80048 | Basic metabolic panel (calcium, ionized) | 7,715 | 5,856 | $34K |
| 36591 | 2,338 | 1,761 | $34K | |
| J7050 | Infusion, normal saline solution, 250 cc | 27,843 | 11,867 | $33K |
| 77063 | Screening digital breast tomosynthesis, bilateral | 1,661 | 1,583 | $33K |
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 178 | 162 | $31K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 56,362 | 41,552 | $29K |
| 72125 | Computed tomography, cervical spine; without contrast material | 832 | 735 | $28K |
| 90715 | 1,432 | 1,311 | $27K | |
| 83880 | 3,767 | 3,169 | $26K | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 6,327 | 4,124 | $26K |
| 41899 | Unlisted procedure, dentoalveolar structures | 15 | 12 | $24K |
| 73030 | 2,388 | 2,130 | $24K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 505 | 466 | $22K |
| 87040 | 3,036 | 1,584 | $21K | |
| J9355 | Injection, trastuzumab, excludes biosimilar, 10 mg | 26 | 12 | $21K |
| 36415 | Collection of venous blood by venipuncture | 60,487 | 43,501 | $21K |
| 96402 | 1,035 | 854 | $20K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 31 | 26 | $19K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 18,677 | 15,681 | $18K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 574 | 507 | $18K |
| 72050 | 946 | 876 | $18K | |
| 93017 | 100 | 85 | $17K | |
| 73130 | 2,701 | 2,353 | $16K | |
| 70486 | 349 | 311 | $16K | |
| Q5118 | Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg | 68 | 12 | $15K |
| 76801 | 533 | 472 | $14K | |
| 84484 | 14,314 | 10,084 | $14K | |
| 85379 | 2,689 | 2,403 | $14K | |
| 71045 | Radiologic examination, chest; single view | 13,449 | 11,532 | $14K |
| 73630 | 2,879 | 2,526 | $13K | |
| 96375 | Therapeutic injection; each additional sequential IV push | 24,347 | 16,357 | $13K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2,500 | 2,035 | $11K |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 151 | 75 | $11K |
| 97535 | Self-care/home management training, each 15 minutes | 379 | 221 | $10K |
| 73502 | 1,174 | 1,044 | $10K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 13,227 | 9,965 | $10K |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 10,721 | 5,446 | $9K |
| 29125 | 44 | 36 | $9K | |
| J3262 | Injection, tocilizumab, 1 mg | 130 | 38 | $9K |
| J7030 | Infusion, normal saline solution , 1000 cc | 20,385 | 15,345 | $8K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 19,161 | 16,462 | $8K |
| 73610 | 2,535 | 2,263 | $8K | |
| 80047 | 1,951 | 1,711 | $7K | |
| 93970 | 38 | 38 | $7K | |
| 73110 | 1,307 | 1,154 | $6K | |
| 83605 | 3,503 | 2,870 | $6K | |
| 80050 | General health panel | 1,194 | 1,020 | $6K |
| 12002 | 27 | 27 | $6K | |
| 81025 | 27,849 | 24,159 | $5K | |
| 90714 | 246 | 212 | $5K | |
| 96417 | 3,760 | 2,220 | $5K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 11,295 | 7,032 | $5K |
| 82728 | 1,657 | 1,359 | $5K | |
| J3490 | Unclassified drugs | 14,041 | 7,140 | $5K |
| J0640 | Injection, leucovorin calcium, per 50 mg | 1,402 | 404 | $5K |
| 90832 | Psychotherapy, 30 minutes with patient | 89 | 26 | $5K |
| 99205 | Prolong outpt/office vis | 26 | 26 | $4K |
| 99215 | Prolong outpt/office vis | 20 | 17 | $4K |
| 36430 | 47 | 38 | $4K | |
| J9263 | Injection, oxaliplatin, 0.5 mg | 175 | 62 | $4K |
| 70496 | 13 | 13 | $4K | |
| 81001 | 41,995 | 35,880 | $4K | |
| 71250 | 67 | 61 | $4K | |
| 70498 | 45 | 43 | $4K | |
| 83550 | 1,545 | 1,252 | $3K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 11,592 | 9,534 | $3K |
| 74018 | 440 | 407 | $3K | |
| J1815 | Injection, insulin, per 5 units | 874 | 291 | $3K |
| 82553 | 740 | 622 | $3K | |
| 83735 | 8,104 | 6,028 | $3K | |
| 73140 | 782 | 724 | $3K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 16,083 | 14,268 | $3K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 378 | 331 | $3K |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 14 | 14 | $3K |
| 83540 | 1,726 | 1,395 | $3K | |
| 80069 | 1,009 | 743 | $3K | |
| 96377 | 457 | 289 | $3K | |
| 12011 | 12 | 12 | $2K | |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 15 | 14 | $2K |
| 96401 | 187 | 115 | $2K | |
| 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 | 4,226 | 3,950 | $2K |
| 97165 | 15 | 12 | $2K | |
| 85027 | 1,461 | 1,107 | $2K | |
| 84100 | 2,146 | 1,530 | $2K | |
| 82962 | 10,745 | 5,798 | $2K | |
| 80179 | 413 | 377 | $2K | |
| 80143 | 454 | 416 | $2K | |
| 86850 | 1,390 | 1,081 | $1K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 11,203 | 9,801 | $1K |
| 76642 | 19 | 13 | $1K | |
| 85018 | 1,094 | 669 | $1K | |
| 87210 | 14,139 | 10,892 | $1K | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 3,490 | 2,286 | $1K |
| 96368 | 814 | 514 | $1K | |
| 86140 | 2,067 | 1,630 | $1K | |
| J2270 | Injection, morphine sulfate, up to 10 mg | 3,694 | 2,955 | $1K |
| 86900 | 1,954 | 1,556 | $1K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 13 | 13 | $1K |
| 84443 | Thyroid stimulating hormone (TSH) | 1,317 | 1,092 | $1K |
| J9190 | Injection, fluorouracil, 500 mg | 2,609 | 647 | $1K |
| 84702 | 2,181 | 1,862 | $960.19 | |
| 83690 | 10,973 | 9,388 | $902.90 | |
| P9016 | Red blood cells, leukocytes reduced, each unit | 16 | 13 | $886.81 |
| 97542 | 14 | 12 | $877.11 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 7,837 | 6,940 | $785.55 |
| 80076 | 377 | 255 | $758.54 | |
| 85652 | 2,202 | 1,708 | $730.31 | |
| 87070 | 7,579 | 6,870 | $699.66 | |
| 87147 | 2,907 | 2,414 | $656.09 | |
| 85014 | 302 | 200 | $641.26 | |
| 73080 | 172 | 155 | $607.97 | |
| 82077 | 3,408 | 2,954 | $596.76 | |
| 86901 | 1,954 | 1,556 | $586.57 | |
| J0780 | Injection, prochlorperazine, up to 10 mg | 1,455 | 1,213 | $576.77 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 10,308 | 4,750 | $575.66 |
| 72131 | 13 | 12 | $557.97 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 4,512 | 2,724 | $556.95 |
| 82550 | 2,329 | 1,836 | $489.92 | |
| 84703 | 1,370 | 1,229 | $488.09 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | 972 | 397 | $473.53 |
| 71101 | 70 | 67 | $467.02 | |
| 72072 | 81 | 76 | $439.34 | |
| 96376 | 3,141 | 2,050 | $429.51 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 7,531 | 6,849 | $424.46 |
| 82378 | 240 | 163 | $405.19 | |
| J3475 | Injection, magnesium sulfate, per 500 mg | 2,010 | 1,226 | $399.81 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 2,150 | 1,742 | $383.90 |
| 85610 | 1,836 | 1,446 | $361.91 | |
| 87077 | 3,769 | 3,222 | $359.08 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 1,675 | 1,509 | $343.11 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 1,169 | 948 | $321.37 |
| 87186 | 3,844 | 3,317 | $315.20 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 716 | 551 | $288.10 |
| 83036 | Hemoglobin; glycosylated (A1C) | 191 | 171 | $276.72 |
| 81003 | 1,633 | 1,435 | $240.91 | |
| 82607 | 45 | 37 | $197.92 | |
| J2060 | Injection, lorazepam, 2 mg | 1,614 | 1,223 | $189.26 |
| 96411 | 1,679 | 977 | $187.74 | |
| 80164 | 15 | 13 | $167.47 | |
| 99218 | 19 | 13 | $145.31 | |
| 82533 | 51 | 39 | $141.12 | |
| J1630 | Injection, haloperidol, up to 5 mg | 776 | 611 | $133.56 |
| 36600 | 229 | 188 | $127.21 | |
| 82784 | 51 | 37 | $81.98 | |
| 86704 | 149 | 115 | $75.56 | |
| 74019 | 13 | 12 | $74.65 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | 1,467 | 1,082 | $69.61 |
| J3480 | Injection, potassium chloride, per 2 meq | 1,494 | 770 | $67.85 |
| 87807 | 562 | 532 | $64.10 | |
| 86706 | 103 | 88 | $60.89 | |
| 73590 | 74 | 65 | $59.59 | |
| 87340 | 142 | 116 | $54.55 | |
| 84165 | 28 | 24 | $50.72 | |
| J9267 | Injection, paclitaxel, 1 mg | 263 | 100 | $47.76 |
| J7510 | Prednisolone oral, per 5 mg | 398 | 376 | $44.10 |
| C9113 | Injection, pantoprazole sodium, per vial | 776 | 601 | $28.13 |
| 82565 | 18 | 16 | $18.01 | |
| 87634 | 284 | 260 | $17.22 | |
| 84439 | 18 | 13 | $16.84 | |
| 80061 | Lipid panel | 14 | 13 | $15.26 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 174 | 141 | $13.14 |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 154 | 102 | $11.65 |
| J0500 | Injection, dicyclomine hcl, up to 20 mg | 536 | 465 | $11.60 |
| J8540 | Dexamethasone, oral, 0.25 mg | 310 | 251 | $10.78 |
| J1644 | Injection, heparin sodium, per 1000 units | 70 | 26 | $7.67 |
| J1170 | Injection, hydromorphone, up to 4 mg | 348 | 224 | $6.03 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 284 | 202 | $5.39 |
| 87088 | 272 | 259 | $4.67 | |
| J2704 | Injection, propofol, 10 mg | 912 | 590 | $4.08 |
| J2550 | Injection, promethazine hcl, up to 50 mg | 19 | 16 | $2.21 |
| 85730 | 87 | 79 | $2.19 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 52 | 38 | $2.02 |
| J3411 | Injection, thiamine hcl, 100 mg | 40 | 26 | $1.71 |
| J2470 | Injection, pantoprazole sodium, 40 mg | 85 | 73 | $1.10 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 112 | 101 | $0.47 |
| J1790 | Injection, droperidol, up to 5 mg | 357 | 299 | $0.36 |
| J2310 | Injection, naloxone hydrochloride, per 1 mg | 242 | 198 | $0.00 |
| 94664 | 203 | 187 | $0.00 | |
| J3370 | Injection, vancomycin hcl, 500 mg | 58 | 14 | $0.00 |
| A9576 | Injection, gadoteridol, (prohance multipack), per ml | 57 | 52 | $0.00 |
| 82272 | 28 | 25 | $0.00 | |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 83 | 67 | $0.00 |
| J3489 | Injection, zoledronic acid, 1 mg | 73 | 52 | $0.00 |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | 20 | 12 | $0.00 |
| 84145 | 50 | 39 | $0.00 | |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | 27 | 24 | $0.00 |
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 26 | 26 | $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 | 21 | 12 | $0.00 |
| J1171 | Injection, hydromorphone, 0.1 mg | 29 | 18 | $0.00 |
| A4565 | Slings | 15 | 15 | $0.00 |
| J2004 | Injection, lidocaine hcl with epinephrine, 1 mg | 12 | 12 | $0.00 |
| 82803 | 85 | 66 | $0.00 | |
| 94760 | 130 | 97 | $0.00 | |
| A9270 | Non-covered item or service | 3,256 | 1,063 | $0.00 |
| 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 | 645 | 594 | $0.00 |
| J9045 | Injection, carboplatin, 50 mg | 566 | 339 | $0.00 |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 92 | 91 | $0.00 |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 359 | 353 | $0.00 |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 38 | 25 | $0.00 |
| 87255 | 53 | 42 | $0.00 | |
| A9579 | Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml | 41 | 36 | $0.00 |
| J1456 | Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg | 76 | 43 | $0.00 |
| 94762 | 35 | 29 | $0.00 | |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 30 | 25 | $0.00 |
| 86592 | 16 | 15 | $0.00 | |
| J1940 | Injection, furosemide, up to 20 mg | 16 | 12 | $0.00 |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 15 | 14 | $0.00 |
| 73090 | 13 | 12 | $0.00 | |
| 72040 | 16 | 15 | $0.00 | |
| 87205 | 17 | 12 | $0.00 | |
| J2785 | Injection, regadenoson, 0.1 mg | 16 | 13 | $0.00 |