NPI: 1447221742 · ROSWELL, NM 88201 · General Acute Care Hospital · NPI assigned 01/27/2006
Authorized official LALOR, PAULA controls 20+ related entities in our dataset. Read more
| Authorized Official | LALOR, PAULA (DIRECTOR/DELEGATED OFFICIAL) |
| NPI Enumeration Date | 01/27/2006 |
Other providers sharing the same authorized official: LALOR, PAULA
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 163,327 | $7.29M |
| 2019 | 114,239 | $5.29M |
| 2020 | 78,456 | $3.95M |
| 2021 | 93,365 | $4.74M |
| 2022 | 134,131 | $6.29M |
| 2023 | 139,062 | $7.01M |
| 2024 | 128,902 | $6.70M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99284 | Emergency department visit for the evaluation and management, high severity | 32,780 | 30,626 | $5.76M |
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 36,897 | 34,875 | $5.61M |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 5,166 | 5,072 | $1.79M |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 3,675 | 3,546 | $1.63M |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 5,096 | 4,834 | $1.41M |
| 70450 | Computed tomography, head or brain; without contrast material | 6,587 | 6,299 | $1.37M |
| 80053 | Comprehensive metabolic panel | 56,913 | 51,662 | $1.35M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 6,695 | 6,267 | $1.32M |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 17,355 | 15,345 | $992K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2,848 | 2,797 | $959K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 2,352 | 2,311 | $936K |
| G0378 | Hospital observation service, per hour | 2,586 | 2,389 | $935K |
| 96375 | Therapeutic injection; each additional sequential IV push | 15,543 | 14,254 | $770K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 59,187 | 51,779 | $767K |
| 71045 | Radiologic examination, chest; single view | 15,895 | 14,905 | $729K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 22,075 | 20,206 | $700K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 1,563 | 1,544 | $688K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 5,867 | 5,714 | $578K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 10,081 | 9,263 | $470K |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | 361 | 360 | $434K |
| 87276 | 12,130 | 11,782 | $422K | |
| 72125 | Computed tomography, cervical spine; without contrast material | 1,723 | 1,666 | $398K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 12,097 | 11,200 | $366K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 4,009 | 3,077 | $356K |
| 93458 | 189 | 183 | $296K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 1,779 | 1,228 | $291K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 11,508 | 11,103 | $290K |
| 84443 | Thyroid stimulating hormone (TSH) | 15,990 | 15,511 | $288K |
| 81001 | 30,527 | 28,252 | $280K | |
| 96361 | Intravenous infusion, hydration; each additional hour | 6,880 | 6,495 | $254K |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | 206 | 204 | $245K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 3,917 | 3,789 | $240K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 2,087 | 2,025 | $209K |
| G0382 | Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | 2,194 | 2,129 | $185K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 9,650 | 9,317 | $179K |
| 80061 | Lipid panel | 13,127 | 12,950 | $172K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 1,067 | 1,065 | $166K |
| 71046 | Radiologic examination, chest; 2 views | 2,613 | 2,529 | $165K |
| 87040 | 3,121 | 2,883 | $161K | |
| 83690 | 9,837 | 9,141 | $154K | |
| 87070 | 8,721 | 8,462 | $150K | |
| 91200 | 1,293 | 1,282 | $150K | |
| 87430 | 5,644 | 5,529 | $146K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 8,782 | 8,297 | $139K |
| 93880 | 1,206 | 1,185 | $137K | |
| 72100 | 1,653 | 1,630 | $137K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 410 | 401 | $130K |
| 82150 | 7,743 | 7,250 | $129K | |
| 84484 | 10,840 | 9,538 | $127K | |
| 86756 | 2,080 | 2,017 | $116K | |
| 80048 | Basic metabolic panel (calcium, ionized) | 5,562 | 4,769 | $114K |
| 82077 | 2,618 | 2,428 | $110K | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 3,789 | 1,070 | $110K |
| 82550 | 9,545 | 8,595 | $109K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 1,592 | 1,524 | $107K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 12,674 | 11,558 | $104K |
| A9270 | Non-covered item or service | 22,161 | 18,784 | $103K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3,392 | 3,304 | $99K |
| 73562 | 1,225 | 1,190 | $99K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 3,817 | 3,727 | $97K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 3,813 | 3,723 | $97K |
| 85610 | 10,593 | 9,621 | $96K | |
| 82553 | 8,409 | 7,543 | $95K | |
| 83605 | 3,397 | 3,092 | $92K | |
| 84703 | 5,270 | 5,028 | $91K | |
| 73030 | 1,241 | 1,196 | $91K | |
| 83036 | Hemoglobin; glycosylated (A1C) | 10,383 | 10,225 | $90K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 4,002 | 3,952 | $89K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1,302 | 1,277 | $86K |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 5,268 | 4,556 | $84K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 247 | 244 | $83K |
| 71250 | 503 | 483 | $80K | |
| 84439 | 6,367 | 6,287 | $78K | |
| 71275 | Computed tomographic angiography, chest, with contrast material | 236 | 229 | $77K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 259 | 251 | $77K |
| 85730 | 7,366 | 6,782 | $76K | |
| 70486 | 329 | 319 | $74K | |
| 83880 | 3,150 | 2,920 | $69K | |
| 87186 | 4,129 | 3,934 | $66K | |
| 80074 | 1,252 | 1,231 | $64K | |
| 83735 | 5,228 | 4,674 | $64K | |
| G0383 | Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | 541 | 529 | $63K |
| 88312 | 846 | 837 | $63K | |
| S5000 | Prescription drug, generic | 9,359 | 6,347 | $63K |
| 80143 | 1,616 | 1,515 | $62K | |
| 36415 | Collection of venous blood by venipuncture | 15,782 | 13,838 | $60K |
| 73610 | 702 | 682 | $59K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 569 | 565 | $57K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 102 | 102 | $52K |
| J2704 | Injection, propofol, 10 mg | 8,942 | 8,502 | $52K |
| 73630 | 858 | 835 | $51K | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 1,273 | 891 | $51K |
| J7030 | Infusion, normal saline solution , 1000 cc | 8,343 | 7,356 | $50K |
| 81025 | 5,067 | 4,909 | $48K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 5,913 | 5,594 | $47K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 568 | 551 | $46K |
| 74018 | 797 | 773 | $46K | |
| 99152 | 547 | 528 | $45K | |
| 59025 | Fetal non-stress test | 380 | 311 | $44K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 1,640 | 583 | $43K |
| 87077 | 4,233 | 4,033 | $43K | |
| 72040 | 461 | 456 | $41K | |
| 82607 | 2,805 | 2,774 | $39K | |
| G0381 | Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | 650 | 642 | $39K |
| 84702 | 1,522 | 1,248 | $38K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 172 | 172 | $37K |
| 85027 | 3,514 | 3,383 | $35K | |
| 86850 | 2,775 | 2,527 | $33K | |
| 84481 | 1,927 | 1,907 | $33K | |
| 87428 | 729 | 708 | $31K | |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 417 | 321 | $30K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 76 | 75 | $30K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 505 | 126 | $29K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1,322 | 1,296 | $29K |
| 73130 | 493 | 479 | $29K | |
| 82105 | 1,154 | 1,140 | $28K | |
| 87324 | 1,302 | 1,275 | $28K | |
| 86703 | 1,709 | 1,676 | $28K | |
| 73620 | 413 | 409 | $27K | |
| 95816 | 144 | 143 | $27K | |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 95 | 72 | $26K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 12,670 | 11,500 | $25K |
| 93971 | 359 | 343 | $25K | |
| 73120 | 254 | 246 | $25K | |
| 86920 | 223 | 182 | $24K | |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 1,664 | 1,604 | $23K |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 7,574 | 7,059 | $22K |
| J0690 | Injection, cefazolin sodium, 500 mg | 2,842 | 2,509 | $21K |
| 83704 | 1,552 | 1,532 | $20K | |
| 86592 | 2,212 | 2,176 | $20K | |
| 82962 | 4,569 | 3,541 | $20K | |
| 82805 | 584 | 524 | $20K | |
| 72131 | 65 | 65 | $20K | |
| 86140 | 2,921 | 2,758 | $19K | |
| 85362 | 827 | 812 | $18K | |
| 86900 | 2,978 | 2,702 | $18K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 5,119 | 4,926 | $18K |
| 73560 | 305 | 298 | $17K | |
| 93017 | 239 | 236 | $17K | |
| 96376 | 1,644 | 1,565 | $17K | |
| 87340 | 860 | 840 | $17K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 141 | 139 | $16K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 549 | 393 | $16K |
| 87522 | Neg quan hep c or qual rna | 324 | 316 | $16K |
| 85651 | 2,037 | 1,919 | $15K | |
| G0380 | Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | 351 | 339 | $15K |
| 76641 | 111 | 110 | $15K | |
| 73110 | 249 | 246 | $15K | |
| 90715 | 482 | 469 | $14K | |
| 83540 | 1,640 | 1,606 | $13K | |
| J1170 | Injection, hydromorphone, up to 4 mg | 2,806 | 2,338 | $13K |
| 29125 | 113 | 110 | $12K | |
| 86803 | 890 | 873 | $12K | |
| 73600 | 121 | 117 | $12K | |
| C9113 | Injection, pantoprazole sodium, per vial | 1,709 | 1,516 | $12K |
| 82728 | 869 | 847 | $12K | |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 218 | 215 | $11K |
| 86038 | 1,112 | 1,097 | $11K | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 879 | 773 | $11K |
| 86762 | 699 | 686 | $11K | |
| J0561 | Injection, penicillin g benzathine, 100,000 units | 99 | 98 | $11K |
| 94760 | 891 | 458 | $10K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 43 | 41 | $10K |
| 87205 | 1,297 | 1,220 | $10K | |
| 83550 | 1,159 | 1,131 | $10K | |
| 86677 | 492 | 482 | $10K | |
| 90714 | 358 | 356 | $10K | |
| 94644 | 94 | 91 | $10K | |
| 86308 | 512 | 505 | $10K | |
| 82140 | 410 | 377 | $10K | |
| 84100 | 875 | 769 | $10K | |
| 36430 | 79 | 65 | $9K | |
| 97161 | 243 | 238 | $9K | |
| 84550 | 1,109 | 1,081 | $9K | |
| 86901 | 2,512 | 2,352 | $9K | |
| J2060 | Injection, lorazepam, 2 mg | 1,780 | 1,591 | $9K |
| 73090 | 146 | 142 | $9K | |
| J2270 | Injection, morphine sulfate, up to 10 mg | 3,773 | 3,044 | $9K |
| 74021 | 68 | 68 | $8K | |
| 82043 | 2,181 | 2,142 | $8K | |
| 12001 | 95 | 95 | $8K | |
| P9016 | Red blood cells, leukocytes reduced, each unit | 73 | 50 | $8K |
| J2785 | Injection, regadenoson, 0.1 mg | 63 | 63 | $7K |
| 93970 | 68 | 63 | $7K | |
| 51702 | 116 | 109 | $7K | |
| 76770 | 94 | 91 | $7K | |
| 86255 | 314 | 309 | $7K | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 2,841 | 2,607 | $7K |
| 76801 | 61 | 57 | $7K | |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 196 | 173 | $6K |
| 86060 | 253 | 249 | $6K | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 1,240 | 1,145 | $6K |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 631 | 612 | $6K |
| 77080 | 69 | 69 | $6K | |
| 73100 | 76 | 75 | $6K | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 3,389 | 3,234 | $5K |
| 74178 | 16 | 16 | $5K | |
| C1769 | Guide wire | 309 | 258 | $5K |
| P9047 | Infusion, albumin (human), 25%, 50 ml | 60 | 24 | $5K |
| 36600 | 305 | 276 | $5K | |
| 84153 | 324 | 321 | $4K | |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 196 | 169 | $4K |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 552 | 483 | $4K |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | 276 | 273 | $4K |
| 86235 | 21 | 21 | $4K | |
| J1644 | Injection, heparin sodium, per 1000 units | 1,023 | 707 | $4K |
| 87045 | 338 | 328 | $4K | |
| 84403 | 257 | 252 | $4K | |
| 73590 | 77 | 72 | $4K | |
| J1650 | Injection, enoxaparin sodium, 10 mg | 586 | 475 | $4K |
| 82248 | 987 | 896 | $4K | |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring | 13 | 13 | $3K |
| J1596 | Injection, glycopyrrolate, 0.1 mg | 359 | 350 | $3K |
| 80050 | General health panel | 53 | 47 | $3K |
| 82947 | 558 | 547 | $3K | |
| 73502 | 61 | 58 | $3K | |
| 77066 | Tomosynthesis, mammo | 14 | 14 | $3K |
| Q0222 | Injection, bebtelovimab, 175 mg | 42 | 42 | $3K |
| 73140 | 41 | 40 | $3K | |
| 94726 | 25 | 25 | $3K | |
| J3370 | Injection, vancomycin hcl, 500 mg | 198 | 154 | $3K |
| 86376 | 219 | 217 | $2K | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 1,236 | 1,157 | $2K |
| 73080 | 42 | 40 | $2K | |
| J3475 | Injection, magnesium sulfate, per 500 mg | 324 | 304 | $2K |
| J7510 | Prednisolone oral, per 5 mg | 501 | 496 | $2K |
| 94060 | 25 | 25 | $2K | |
| 82570 | 207 | 195 | $2K | |
| 86780 | 90 | 87 | $2K | |
| 97162 | 39 | 39 | $2K | |
| 95812 | 14 | 13 | $2K | |
| 84146 | 83 | 82 | $2K | |
| 87420 | 107 | 107 | $2K | |
| 84466 | 99 | 99 | $2K | |
| 87081 | 69 | 68 | $2K | |
| 76819 | Fetal biophysical profile; without non-stress testing | 16 | 13 | $2K |
| 0012A | 42 | 42 | $2K | |
| 84156 | 230 | 217 | $2K | |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | 77 | 74 | $2K |
| J1171 | Injection, hydromorphone, 0.1 mg | 120 | 97 | $2K |
| 86787 | 211 | 211 | $2K | |
| 84402 | 95 | 94 | $2K | |
| 83001 | 70 | 68 | $1K | |
| 86336 | 73 | 71 | $1K | |
| 82670 | 55 | 54 | $1K | |
| J0171 | Injection, adrenalin, epinephrine, 0.1 mg | 376 | 368 | $1K |
| 86141 | 123 | 121 | $1K | |
| 76536 | 12 | 12 | $1K | |
| 87177 | 166 | 161 | $1K | |
| 87338 | 102 | 100 | $1K | |
| 72170 | 26 | 25 | $1K | |
| 82746 | 127 | 126 | $1K | |
| 83615 | 103 | 92 | $1K | |
| J0360 | Injection, hydralazine hcl, up to 20 mg | 86 | 76 | $1K |
| 82390 | 122 | 121 | $1K | |
| 74019 | 13 | 13 | $1K | |
| 86430 | 166 | 165 | $1K | |
| 94729 | 25 | 25 | $1K | |
| A9579 | Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml | 362 | 358 | $1K |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 86 | 83 | $1K |
| 71111 | 14 | 13 | $1K | |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 61 | 29 | $1K |
| 73501 | 14 | 12 | $1K | |
| 76010 | 13 | 13 | $975.13 | |
| J2550 | Injection, promethazine hcl, up to 50 mg | 328 | 305 | $941.22 |
| 82565 | 107 | 104 | $872.34 | |
| J2470 | Injection, pantoprazole sodium, 40 mg | 166 | 158 | $866.06 |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 108 | 107 | $802.25 |
| 96367 | 13 | 13 | $782.80 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 88 | 81 | $782.25 |
| 83002 | 41 | 39 | $774.77 | |
| 73070 | 12 | 12 | $766.86 | |
| 99153 | Mod sedat endo service >5yrs | 75 | 72 | $730.22 |
| J1956 | Injection, levofloxacin, 250 mg | 147 | 128 | $708.82 |
| 86694 | 28 | 28 | $696.76 | |
| 82010 | 68 | 63 | $689.22 | |
| C1768 | Graft, vascular | 13 | 13 | $652.15 |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 45 | 45 | $648.69 |
| 81003 | 262 | 255 | $580.89 | |
| G0008 | Administration of influenza virus vaccine | 27 | 26 | $514.46 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 362 | 336 | $493.81 |
| 73552 | 13 | 12 | $486.97 | |
| J3480 | Injection, potassium chloride, per 2 meq | 118 | 107 | $486.70 |
| 86225 | 32 | 32 | $468.70 | |
| J1815 | Injection, insulin, per 5 units | 1,126 | 613 | $463.30 |
| 80179 | 69 | 67 | $397.34 | |
| 91301 | 58 | 58 | $369.48 | |
| 82272 | 87 | 82 | $361.03 | |
| J7050 | Infusion, normal saline solution, 250 cc | 299 | 221 | $357.75 |
| J2370 | Injection, phenylephrine hcl, up to 1 ml | 93 | 85 | $356.76 |
| 82247 | 38 | 27 | $348.93 | |
| J3486 | Injection, ziprasidone mesylate, 10 mg | 14 | 14 | $326.04 |
| 83525 | 25 | 25 | $291.54 | |
| 86705 | 21 | 20 | $257.91 | |
| 86709 | 43 | 42 | $243.71 | |
| 87210 | 18 | 16 | $189.06 | |
| G9019 | Oseltamivir phosphate, oral, per 75 mg (for use in a medicare-approved demonstration project) | 16 | 14 | $187.44 |
| 89050 | 44 | 43 | $164.50 | |
| J3371 | Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg | 13 | 12 | $156.75 |
| 80069 | 15 | 15 | $141.27 | |
| J3360 | Injection, diazepam, up to 5 mg | 16 | 13 | $85.44 |
| J1953 | Injection, levetiracetam, 10 mg | 13 | 13 | $76.87 |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 27 | 27 | $72.81 |
| J1940 | Injection, furosemide, up to 20 mg | 12 | 12 | $46.67 |
| 82950 | 13 | 12 | $41.22 | |
| 85379 | 12 | 12 | $29.18 | |
| 85007 | 14 | 12 | $28.08 | |
| G8979 | Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting | 28 | 28 | $0.00 |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | 26 | 26 | $0.00 |
| Q0244 | Injection, casirivimab and imdevimab, 1200 mg | 169 | 169 | $0.00 |