NPI: 1457304495 · GREENVILLE, MI 48838 · General Acute Care Hospital · NPI assigned 05/19/2006
Authorized official COX, MATTHEW controls 20+ related entities in our dataset. Read more
| Authorized Official | COX, MATTHEW (CFO) |
| NPI Enumeration Date | 05/19/2006 |
Other providers sharing the same authorized official: COX, MATTHEW
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 77,652 | $2.13M |
| 2019 | 71,127 | $1.88M |
| 2020 | 82,985 | $2.37M |
| 2021 | 128,594 | $3.77M |
| 2022 | 124,971 | $3.66M |
| 2023 | 128,345 | $3.64M |
| 2024 | 114,492 | $3.54M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99284 | Emergency department visit for the evaluation and management, high severity | 20,020 | 18,875 | $3.92M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 12,213 | 11,449 | $3.64M |
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 18,906 | 18,137 | $2.37M |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 14,051 | 12,780 | $1.37M |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 4,953 | 4,816 | $698K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 28,668 | 8,142 | $688K |
| 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 | 7,921 | 7,605 | $480K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 8,172 | 7,114 | $475K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 5,405 | 5,286 | $386K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 1,959 | 1,309 | $336K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 3,009 | 2,946 | $290K |
| 96361 | Intravenous infusion, hydration; each additional hour | 9,970 | 8,786 | $286K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 2,774 | 2,453 | $274K |
| 71046 | Radiologic examination, chest; 2 views | 7,130 | 6,856 | $267K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 2,789 | 2,357 | $248K |
| 96375 | Therapeutic injection; each additional sequential IV push | 10,768 | 9,234 | $222K |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 10,472 | 3,877 | $194K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 1,135 | 1,133 | $186K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 711 | 706 | $173K |
| G0378 | Hospital observation service, per hour | 1,317 | 839 | $170K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 2,722 | 2,663 | $161K |
| 93975 | 1,333 | 1,298 | $160K | |
| 76830 | Ultrasound, transvaginal | 2,492 | 2,449 | $144K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 4,843 | 4,657 | $143K |
| 86900 | 3,161 | 3,010 | $127K | |
| G0482 | 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; 15-21 drug class(es), including metabolite(s) if performed | 2,058 | 1,912 | $120K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 2,214 | 2,180 | $117K |
| 71275 | Computed tomographic angiography, chest, with contrast material | 1,593 | 1,546 | $113K |
| 70450 | Computed tomography, head or brain; without contrast material | 2,625 | 2,545 | $109K |
| 97162 | 2,294 | 2,263 | $107K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 8,415 | 3,355 | $100K |
| 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 | 5,564 | 5,384 | $99K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 6,490 | 6,404 | $98K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 6,455 | 6,372 | $98K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 897 | 888 | $97K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 6,024 | 5,695 | $97K |
| 82947 | 4,138 | 3,038 | $96K | |
| 36415 | Collection of venous blood by venipuncture | 39,623 | 33,723 | $94K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 1,975 | 1,973 | $90K |
| 71045 | Radiologic examination, chest; single view | 2,151 | 2,076 | $87K |
| 80061 | Lipid panel | 8,424 | 8,381 | $80K |
| 80050 | General health panel | 2,806 | 2,735 | $78K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 1,351 | 1,333 | $75K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 9,627 | 9,231 | $70K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 308 | 306 | $69K |
| 80053 | Comprehensive metabolic panel | 34,063 | 30,224 | $68K |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 627 | 624 | $63K |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | 3,464 | 3,452 | $58K |
| 84443 | Thyroid stimulating hormone (TSH) | 8,610 | 8,434 | $56K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 7,376 | 6,246 | $56K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 903 | 898 | $54K |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | 1,994 | 1,990 | $50K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 229 | 225 | $45K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 33,284 | 29,181 | $42K |
| 97535 | Self-care/home management training, each 15 minutes | 2,538 | 2,133 | $40K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 82 | 81 | $37K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 875 | 869 | $35K |
| 72100 | 980 | 975 | $31K | |
| 76642 | 753 | 748 | $30K | |
| 71250 | 526 | 526 | $30K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 2,378 | 2,365 | $29K |
| 72125 | Computed tomography, cervical spine; without contrast material | 380 | 375 | $27K |
| 93971 | 502 | 494 | $27K | |
| 96367 | 533 | 365 | $26K | |
| 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 | 1,593 | 1,471 | $26K |
| G0432 | Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening | 2,294 | 2,287 | $25K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 1,319 | 1,314 | $24K |
| 83036 | Hemoglobin; glycosylated (A1C) | 6,010 | 5,988 | $24K |
| C9399 | Unclassified drugs or biologicals | 411 | 405 | $23K |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | 74 | 73 | $23K |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision | 1,494 | 1,494 | $22K |
| 70498 | 151 | 150 | $21K | |
| 87653 | 1,179 | 1,178 | $21K | |
| 86780 | 2,760 | 2,755 | $20K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 43 | 43 | $19K |
| 73562 | 1,305 | 1,262 | $18K | |
| 76801 | 314 | 310 | $18K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 8,751 | 8,342 | $17K |
| 82728 | 2,780 | 2,721 | $17K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | 1,400 | 1,400 | $17K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 3,241 | 3,042 | $17K |
| 73630 | 2,229 | 2,094 | $17K | |
| 85027 | 8,431 | 7,765 | $16K | |
| 73030 | 1,365 | 1,306 | $16K | |
| 96415 | 384 | 281 | $14K | |
| 80048 | Basic metabolic panel (calcium, ionized) | 6,041 | 4,978 | $13K |
| 84702 | 2,797 | 2,073 | $13K | |
| 76536 | 234 | 233 | $12K | |
| Q3014 | Telehealth originating site facility fee | 600 | 565 | $11K |
| 84439 | 2,696 | 2,613 | $11K | |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | 13 | 12 | $11K |
| 73610 | 1,616 | 1,548 | $11K | |
| 73130 | 1,425 | 1,388 | $11K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 11,943 | 10,818 | $11K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 26 | 26 | $10K |
| 0002A | 289 | 289 | $10K | |
| G0475 | Hiv antigen/antibody, combination assay, screening | 751 | 750 | $10K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 53 | 53 | $10K |
| 83550 | 2,413 | 2,378 | $9K | |
| 87081 | 4,168 | 4,129 | $9K | |
| 82607 | 1,599 | 1,593 | $9K | |
| 87077 | 3,564 | 3,410 | $9K | |
| 72141 | 62 | 62 | $9K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 979 | 968 | $8K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 25 | 25 | $8K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 519 | 263 | $8K |
| 96376 | 2,514 | 1,960 | $8K | |
| 87186 | 2,710 | 2,608 | $7K | |
| 74018 | 293 | 283 | $7K | |
| 83880 | 2,130 | 1,940 | $7K | |
| 43249 | 12 | 12 | $7K | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 344 | 308 | $7K |
| 83540 | 2,486 | 2,448 | $7K | |
| 0001A | 291 | 291 | $7K | |
| 87205 | 4,890 | 4,667 | $7K | |
| 83655 | 959 | 940 | $7K | |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 578 | 571 | $6K |
| 77066 | Tomosynthesis, mammo | 109 | 108 | $6K |
| 85610 | 4,401 | 3,200 | $6K | |
| 73110 | 879 | 848 | $6K | |
| 83735 | 5,839 | 4,987 | $6K | |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 224 | 211 | $6K |
| 82746 | 854 | 850 | $6K | |
| 82570 | 2,736 | 2,635 | $5K | |
| 87340 | 2,516 | 2,506 | $5K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 499 | 465 | $5K |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 43 | 43 | $4K |
| 71271 | 86 | 86 | $4K | |
| 81001 | 19,236 | 17,305 | $4K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 151 | 146 | $4K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 1,975 | 1,649 | $4K |
| 76770 | 68 | 67 | $4K | |
| 97163 | 86 | 86 | $4K | |
| 82950 | 1,396 | 1,393 | $4K | |
| 82043 | 1,291 | 1,285 | $4K | |
| 80074 | 172 | 172 | $4K | |
| 59025 | Fetal non-stress test | 39 | 28 | $4K |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 358 | 358 | $3K |
| 86140 | 2,329 | 2,118 | $3K | |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 191 | 190 | $3K |
| 84403 | 210 | 207 | $3K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 25 | 25 | $3K |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 63 | 63 | $3K |
| 70491 | 25 | 24 | $3K | |
| 0012A | 84 | 84 | $3K | |
| 87070 | 1,001 | 949 | $3K | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 62 | 26 | $2K |
| 97161 | 60 | 60 | $2K | |
| 84484 | 7,636 | 4,868 | $2K | |
| 70496 | 238 | 237 | $2K | |
| 80076 | 541 | 513 | $2K | |
| 84100 | 1,569 | 1,245 | $2K | |
| 70486 | 38 | 38 | $2K | |
| 0011A | 87 | 87 | $2K | |
| 86038 | 330 | 327 | $2K | |
| 84146 | 174 | 169 | $2K | |
| 85652 | 2,235 | 2,115 | $2K | |
| 82565 | 3,602 | 3,488 | $2K | |
| 83970 | 83 | 83 | $2K | |
| 81025 | 10,598 | 9,981 | $2K | |
| 77065 | Tomosynthesis, mammo | 38 | 36 | $1K |
| 73502 | 109 | 109 | $1K | |
| 73221 | 12 | 12 | $1K | |
| 93017 | 86 | 86 | $1K | |
| 82533 | 204 | 162 | $1K | |
| 97116 | 96 | 49 | $1K | |
| 87147 | 742 | 725 | $1K | |
| 97597 | 16 | 14 | $1K | |
| 93246 | 80 | 80 | $1K | |
| 73140 | 91 | 90 | $1K | |
| 84425 | 101 | 101 | $1K | |
| 83690 | 6,679 | 6,165 | $1K | |
| 82784 | 179 | 170 | $1K | |
| 84156 | 1,082 | 1,012 | $958.64 | |
| 86905 | 13 | 13 | $936.70 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 10,118 | 9,358 | $787.01 |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 684 | 628 | $782.24 |
| 85007 | 983 | 862 | $720.83 | |
| 85730 | 1,017 | 970 | $696.74 | |
| 87808 | 1,359 | 1,342 | $657.96 | |
| 72040 | 24 | 24 | $580.56 | |
| 73080 | 164 | 160 | $568.40 | |
| 83001 | 55 | 55 | $518.49 | |
| 86762 | 1,444 | 1,442 | $443.65 | |
| 87563 | 28 | 28 | $441.36 | |
| 83615 | 237 | 205 | $426.75 | |
| 80069 | 98 | 87 | $382.55 | |
| 84550 | 389 | 375 | $366.80 | |
| 73564 | 12 | 12 | $364.62 | |
| 84145 | 71 | 62 | $347.96 | |
| 86850 | 2,935 | 2,824 | $296.25 | |
| 84112 | 31 | 24 | $286.95 | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 27 | 26 | $259.78 |
| 85379 | 1,322 | 1,297 | $259.46 | |
| 73590 | 75 | 75 | $254.71 | |
| 82248 | 119 | 99 | $233.44 | |
| 82247 | 74 | 49 | $196.15 | |
| 82670 | 12 | 12 | $171.49 | |
| 87040 | 427 | 294 | $171.42 | |
| 12001 | 163 | 163 | $160.61 | |
| 83516 | 19 | 15 | $157.78 | |
| 87503 | 32 | 31 | $148.28 | |
| 86431 | 55 | 55 | $144.16 | |
| 85240 | 12 | 12 | $125.64 | |
| 83605 | 2,766 | 2,245 | $125.05 | |
| 85014 | 544 | 512 | $119.72 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1,925 | 1,905 | $115.59 |
| 85055 | 17 | 12 | $97.75 | |
| 87088 | 42 | 42 | $83.28 | |
| 82330 | 222 | 202 | $53.63 | |
| 84132 | 283 | 273 | $43.19 | |
| 82550 | 29 | 27 | $32.04 | |
| 88304 | 26 | 24 | $22.75 | |
| 82077 | 531 | 506 | $19.55 | |
| 85018 | 18 | 14 | $7.92 | |
| 87807 | 59 | 58 | $7.79 | |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 1,257 | 1,210 | $4.67 |
| 84295 | 157 | 151 | $2.68 | |
| A9577 | Injection, gadobenate dimeglumine (multihance), per ml | 1,089 | 1,074 | $0.01 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 3,633 | 3,123 | $0.00 |
| A9270 | Non-covered item or service | 1,109 | 750 | $0.00 |
| A9579 | Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml | 237 | 227 | $0.00 |
| J2704 | Injection, propofol, 10 mg | 3,153 | 2,938 | $0.00 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 6,438 | 4,413 | $0.00 |
| J0690 | Injection, cefazolin sodium, 500 mg | 1,088 | 1,045 | $0.00 |
| J1170 | Injection, hydromorphone, up to 4 mg | 2,637 | 2,035 | $0.00 |
| J8540 | Dexamethasone, oral, 0.25 mg | 111 | 109 | $0.00 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 11,000 | 10,134 | $0.00 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 1,232 | 1,153 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 1,353 | 1,229 | $0.00 |
| J1790 | Injection, droperidol, up to 5 mg | 265 | 237 | $0.00 |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 2,386 | 1,296 | $0.00 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 5,199 | 3,805 | $0.00 |
| J7121 | 5% dextrose in lactated ringers infusion, up to 1000 cc | 1,536 | 1,514 | $0.00 |
| J7050 | Infusion, normal saline solution, 250 cc | 15,954 | 10,706 | $0.00 |
| J1630 | Injection, haloperidol, up to 5 mg | 697 | 610 | $0.00 |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 61 | 58 | $0.00 |
| A9573 | Injection, gadopiclenol, 1 ml | 154 | 154 | $0.00 |
| 76377 | 113 | 113 | $0.00 | |
| J2060 | Injection, lorazepam, 2 mg | 526 | 439 | $0.00 |
| 91301 | 178 | 178 | $0.00 | |
| 86901 | 162 | 154 | $0.00 | |
| 82803 | 141 | 129 | $0.00 | |
| C1726 | Catheter, balloon dilatation, non-vascular | 12 | 12 | $0.00 |
| J7060 | 5% dextrose/water (500 ml = 1 unit) | 75 | 30 | $0.00 |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 59 | 55 | $0.00 |
| J2785 | Injection, regadenoson, 0.1 mg | 29 | 29 | $0.00 |
| C1889 | Implantable/insertable device, not otherwise classified | 74 | 73 | $0.00 |
| 73090 | 42 | 40 | $0.00 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 1,051 | 841 | $0.00 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 1,379 | 1,259 | $0.00 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 8,344 | 8,049 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 3,876 | 3,427 | $0.00 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 8,544 | 7,502 | $0.00 |
| J7030 | Infusion, normal saline solution , 1000 cc | 13,256 | 11,476 | $0.00 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 2,458 | 2,162 | $0.00 |
| 90715 | 320 | 317 | $0.00 | |
| C1751 | Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) | 14 | 12 | $0.00 |
| 80143 | 254 | 246 | $0.00 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | 3,380 | 3,093 | $0.00 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 615 | 562 | $0.00 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | 341 | 339 | $0.00 |
| 99152 | 322 | 319 | $0.00 | |
| 80179 | 178 | 173 | $0.00 | |
| J1171 | Injection, hydromorphone, 0.1 mg | 39 | 31 | $0.00 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 95 | 68 | $0.00 |
| J2550 | Injection, promethazine hcl, up to 50 mg | 72 | 64 | $0.00 |
| 91300 | 577 | 505 | $0.00 | |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 130 | 125 | $0.00 |
| C9113 | Injection, pantoprazole sodium, per vial | 15 | 12 | $0.00 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 42 | 42 | $0.00 |
| J1644 | Injection, heparin sodium, per 1000 units | 21 | 12 | $0.00 |