NPI: 1477591055 · GREENSBORO, NC 27401 · General Acute Care Hospital · NPI assigned 06/03/2006
Authorized official WARD, ELIZABETH controls 20+ related entities in our dataset. Read more
| Authorized Official | WARD, ELIZABETH (CFO/TREASURER) |
| NPI Enumeration Date | 06/03/2006 |
Other providers sharing the same authorized official: WARD, ELIZABETH
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 319,033 | $13.17M |
| 2019 | 270,398 | $12.76M |
| 2020 | 206,385 | $8.32M |
| 2021 | 288,656 | $16.11M |
| 2022 | 329,719 | $24.55M |
| 2023 | 381,805 | $26.78M |
| 2024 | 421,446 | $31.42M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 94,992 | 86,686 | $31.71M |
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 170,138 | 157,628 | $30.93M |
| 99284 | Emergency department visit for the evaluation and management, high severity | 116,830 | 107,785 | $29.06M |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 26,663 | 24,573 | $4.75M |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 17,212 | 14,955 | $1.99M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 14,221 | 13,340 | $1.77M |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 54,233 | 49,058 | $1.77M |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 54,212 | 49,044 | $1.67M |
| 71046 | Radiologic examination, chest; 2 views | 37,412 | 34,751 | $1.47M |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 62,095 | 53,706 | $1.35M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 69,984 | 56,289 | $1.32M |
| 80053 | Comprehensive metabolic panel | 124,132 | 104,472 | $1.14M |
| 96361 | Intravenous infusion, hydration; each additional hour | 25,727 | 22,212 | $1.14M |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 32,673 | 29,781 | $1.01M |
| 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 | 12,434 | 11,139 | $1.00M |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 35,611 | 30,863 | $956K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 7,496 | 6,626 | $840K |
| 76819 | Fetal biophysical profile; without non-stress testing | 6,753 | 3,846 | $787K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 112,178 | 93,093 | $777K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 20,124 | 17,374 | $731K |
| 96375 | Therapeutic injection; each additional sequential IV push | 18,223 | 15,671 | $723K |
| 70450 | Computed tomography, head or brain; without contrast material | 3,424 | 3,132 | $713K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 19,599 | 17,607 | $684K |
| 41899 | Unlisted procedure, dentoalveolar structures | 932 | 823 | $622K |
| T2016 | Habilitation, residential, waiver; per diem | 2,864 | 1,782 | $622K |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | 21,773 | 19,373 | $591K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 1,169 | 1,099 | $590K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 20,490 | 18,569 | $528K |
| 87481 | 16,897 | 15,269 | $521K | |
| 87511 | 15,880 | 14,456 | $488K | |
| J3490 | Unclassified drugs | 129,347 | 62,556 | $460K |
| 85027 | 65,516 | 58,691 | $429K | |
| 71045 | Radiologic examination, chest; single view | 9,544 | 8,587 | $425K |
| 90791 | Psychiatric diagnostic evaluation | 4,758 | 4,040 | $390K |
| 76820 | 3,896 | 1,801 | $343K | |
| 80048 | Basic metabolic panel (calcium, ionized) | 42,672 | 38,583 | $333K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 3,095 | 2,744 | $306K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 5,925 | 4,973 | $292K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 14,710 | 11,229 | $290K |
| 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 | 6,666 | 5,455 | $287K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 4,071 | 3,495 | $274K |
| 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 | 10,154 | 9,036 | $274K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 4,335 | 4,124 | $258K |
| J2505 | Injection, pegfilgrastim, 6 mg | 258 | 185 | $246K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 1,731 | 1,519 | $234K |
| 76801 | 1,957 | 1,723 | $211K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 5,442 | 5,154 | $207K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 2,919 | 1,564 | $196K |
| S9484 | Crisis intervention mental health services, per hour | 1,020 | 198 | $192K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 17,569 | 16,660 | $186K |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 6,110 | 5,367 | $183K |
| J7030 | Infusion, normal saline solution , 1000 cc | 19,666 | 17,692 | $182K |
| 84702 | 18,796 | 16,474 | $178K | |
| 84484 | 23,295 | 14,651 | $175K | |
| 83690 | 24,885 | 22,729 | $171K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 2,961 | 2,029 | $156K |
| A9270 | Non-covered item or service | 291,168 | 147,201 | $151K |
| G0378 | Hospital observation service, per hour | 1,131 | 514 | $148K |
| 81025 | 16,129 | 14,640 | $132K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 1,465 | 1,320 | $130K |
| 59025 | Fetal non-stress test | 1,950 | 1,134 | $123K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 1,017 | 980 | $121K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 2,723 | 2,458 | $116K |
| 87486 | 2,813 | 2,595 | $115K | |
| 87581 | 2,813 | 2,595 | $113K | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 2,162 | 829 | $109K |
| 81001 | 31,975 | 29,873 | $108K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 6,726 | 6,202 | $102K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 1,686 | 991 | $102K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 6,998 | 6,695 | $99K |
| 76818 | 1,239 | 738 | $95K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 266 | 207 | $71K |
| J7120 | Ringers lactate infusion, up to 1000 cc | 5,165 | 4,473 | $70K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 2,375 | 2,050 | $69K |
| J7050 | Infusion, normal saline solution, 250 cc | 10,640 | 4,560 | $63K |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2,187 | 1,972 | $63K |
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1,360 | 1,196 | $62K |
| 87086 | Culture, bacterial; quantitative colony count, urine | 5,973 | 5,573 | $62K |
| 83036 | Hemoglobin; glycosylated (A1C) | 4,597 | 4,303 | $58K |
| 87631 | 1,652 | 1,489 | $57K | |
| 87081 | 6,595 | 6,322 | $55K | |
| J2469 | Injection, palonosetron hcl, 25 mcg | 636 | 374 | $54K |
| 87210 | 11,588 | 10,658 | $53K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 944 | 918 | $51K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 604 | 369 | $46K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 223 | 213 | $44K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 902 | 561 | $44K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | 162 | 144 | $44K |
| 77336 | 446 | 181 | $43K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 478 | 429 | $38K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 2,676 | 2,047 | $35K |
| 87660 | 1,460 | 1,414 | $34K | |
| M0247 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring | 122 | 93 | $33K |
| 77334 | 54 | 36 | $33K | |
| 36415 | Collection of venous blood by venipuncture | 9,861 | 8,367 | $33K |
| 82947 | 5,986 | 3,458 | $31K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2,261 | 2,137 | $30K |
| J2704 | Injection, propofol, 10 mg | 2,450 | 1,812 | $30K |
| 74018 | 498 | 465 | $29K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 68 | 63 | $28K |
| 90686 | 8,164 | 7,568 | $27K | |
| 82728 | 2,452 | 2,204 | $26K | |
| 36591 | 1,588 | 916 | $26K | |
| 97597 | 832 | 462 | $25K | |
| 90715 | 2,943 | 2,598 | $25K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1,535 | 1,412 | $23K |
| 83880 | 655 | 603 | $22K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 161 | 143 | $21K |
| 90651 | 1,313 | 1,263 | $21K | |
| J0897 | Injection, denosumab, 1 mg | 57 | 53 | $21K |
| 92567 | 788 | 725 | $21K | |
| 41874 | 27 | 25 | $20K | |
| J0741 | Injection, cabotegravir and rilpivirine, 2mg/3mg | 141 | 134 | $19K |
| 99215 | Prolong outpt/office vis | 497 | 449 | $19K |
| 96367 | 668 | 358 | $18K | |
| 92579 | 190 | 173 | $18K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 7,034 | 6,186 | $17K |
| 81003 | 6,355 | 5,993 | $17K | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 3,338 | 1,575 | $15K |
| 90677 | 523 | 514 | $14K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 5,459 | 4,599 | $14K |
| 81513 | 1,090 | 884 | $14K | |
| 90474 | 1,955 | 1,902 | $13K | |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring | 96 | 69 | $13K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 4,880 | 4,264 | $13K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 272 | 198 | $12K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 245 | 64 | $12K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 71 | 64 | $12K |
| 0124A | 193 | 189 | $12K | |
| 76830 | Ultrasound, transvaginal | 83 | 76 | $11K |
| 90670 | 3,300 | 3,149 | $11K | |
| 92587 | 183 | 179 | $11K | |
| 95816 | 101 | 84 | $11K | |
| 83550 | 1,654 | 1,513 | $10K | |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 30 | 27 | $10K |
| 92588 | 123 | 106 | $10K | |
| 83735 | 1,952 | 1,237 | $10K | |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 42 | 28 | $9K |
| 84703 | 784 | 730 | $8K | |
| 91320 | 199 | 195 | $8K | |
| 83540 | 1,654 | 1,513 | $8K | |
| J1756 | Injection, iron sucrose, 1 mg | 361 | 187 | $7K |
| 76882 | 140 | 124 | $7K | |
| 11981 | 110 | 98 | $7K | |
| 93971 | 46 | 44 | $7K | |
| 90480 | 209 | 204 | $7K | |
| 87428 | 76 | 74 | $6K | |
| 0002A | 133 | 110 | $6K | |
| 83615 | 1,860 | 1,549 | $6K | |
| J3486 | Injection, ziprasidone mesylate, 10 mg | 401 | 194 | $6K |
| J1453 | Injection, fosaprepitant, 1 mg | 80 | 50 | $6K |
| 0054A | 129 | 109 | $6K | |
| 0001A | 123 | 101 | $5K | |
| 93922 | 262 | 240 | $5K | |
| 81002 | 1,482 | 1,386 | $5K | |
| 90734 | 931 | 881 | $5K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 156 | 149 | $5K |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 1,547 | 1,219 | $5K |
| 92557 | 46 | 45 | $5K | |
| 87480 | 188 | 176 | $4K | |
| 82607 | 441 | 404 | $4K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 67 | 25 | $4K |
| M0239 | Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring | 22 | 17 | $4K |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 7,101 | 3,461 | $4K |
| 85045 | 1,519 | 1,040 | $4K | |
| 86900 | 1,086 | 826 | $4K | |
| 86901 | 1,086 | 826 | $4K | |
| 85018 | 1,188 | 1,127 | $4K | |
| 29581 | 177 | 75 | $4K | |
| 94761 | 537 | 358 | $4K | |
| 77300 | 13 | 12 | $3K | |
| 58300 | 78 | 70 | $3K | |
| J7297 | Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg | 17 | 12 | $3K |
| J2060 | Injection, lorazepam, 2 mg | 1,092 | 663 | $3K |
| 92552 | 141 | 135 | $3K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 156 | 141 | $3K |
| 84443 | Thyroid stimulating hormone (TSH) | 266 | 191 | $3K |
| 96127 | 1,044 | 968 | $2K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 401 | 386 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 123 | 96 | $2K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 136 | 68 | $2K |
| 99173 | 371 | 359 | $2K | |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | 2,933 | 1,366 | $2K |
| 90656 | 606 | 605 | $2K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 12 | 12 | $2K |
| 43450 | 12 | 12 | $2K | |
| 92558 | 29 | 26 | $2K | |
| 0004A | 39 | 33 | $2K | |
| C9399 | Unclassified drugs or biologicals | 21 | 13 | $2K |
| 92551 | 266 | 262 | $2K | |
| 90716 | 1,901 | 1,825 | $2K | |
| 36416 | 939 | 850 | $2K | |
| J9190 | Injection, fluorouracil, 500 mg | 40 | 24 | $1K |
| 87077 | 100 | 96 | $1K | |
| J0561 | Injection, penicillin g benzathine, 100,000 units | 23 | 17 | $1K |
| 0051A | 25 | 24 | $1K | |
| 82746 | 134 | 124 | $1K | |
| 99172 | 86 | 82 | $1K | |
| J1170 | Injection, hydromorphone, up to 4 mg | 385 | 325 | $1K |
| 90707 | 1,818 | 1,747 | $1K | |
| 0003A | 27 | 27 | $1K | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 417 | 353 | $1K |
| J7042 | 5% dextrose/normal saline (500 ml = 1 unit) | 449 | 234 | $1K |
| 82962 | 230 | 168 | $961.23 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 530 | 315 | $909.88 |
| 0071A | 13 | 13 | $739.40 | |
| 90837 | Psychotherapy, 53 minutes with patient | 18 | 12 | $737.19 |
| 88312 | 12 | 12 | $696.06 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 42 | 26 | $686.34 |
| 94726 | 13 | 13 | $649.06 | |
| 99205 | Prolong outpt/office vis | 14 | 14 | $641.16 |
| 99201 | 91 | 85 | $639.29 | |
| 86850 | 37 | 36 | $618.12 | |
| J0248 | Injection, remdesivir, 1 mg | 338 | 14 | $612.62 |
| 74019 | 13 | 12 | $609.00 | |
| J0689 | Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg | 95 | 85 | $594.09 |
| 82378 | 57 | 37 | $588.06 | |
| 93926 | 13 | 13 | $584.21 | |
| 72110 | 13 | 12 | $581.05 | |
| J0690 | Injection, cefazolin sodium, 500 mg | 101 | 92 | $577.55 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 210 | 196 | $524.27 |
| 83921 | 43 | 39 | $498.69 | |
| 86592 | 66 | 60 | $426.95 | |
| 20610 | 15 | 12 | $409.16 | |
| V2632 | Posterior chamber intraocular lens | 14 | 12 | $403.07 |
| 96376 | 82 | 52 | $397.34 | |
| 85046 | 67 | 65 | $385.68 | |
| 87186 | 28 | 27 | $382.53 | |
| 90732 | 14 | 12 | $333.30 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 407 | 381 | $318.16 |
| 83883 | 57 | 25 | $306.72 | |
| 84165 | 91 | 74 | $293.33 | |
| 90723 | 2,757 | 2,658 | $283.30 | |
| 85610 | 75 | 61 | $260.37 | |
| 80047 | 16 | 12 | $226.83 | |
| 85379 | 14 | 13 | $221.08 | |
| 90680 | 2,017 | 1,959 | $211.61 | |
| 83605 | 14 | 13 | $190.75 | |
| 83010 | 18 | 12 | $188.29 | |
| 90647 | 2,759 | 2,649 | $178.99 | |
| 82570 | 27 | 25 | $158.96 | |
| 82948 | 46 | 38 | $141.73 | |
| Q0144 | Azithromycin dihydrate, oral, capsules/powder, 1 gram | 26 | 25 | $133.44 |
| 99000 | 170 | 149 | $131.18 | |
| J7644 | Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram | 153 | 148 | $115.35 |
| 84156 | 27 | 25 | $112.67 | |
| 87510 | 187 | 175 | $99.96 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | 19 | 12 | $78.52 |
| 99406 | 25 | 25 | $72.63 | |
| J1630 | Injection, haloperidol, up to 5 mg | 42 | 15 | $70.47 |
| 76813 | 19 | 14 | $68.17 | |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 13 | 13 | $63.12 |
| 90633 | 2,070 | 1,971 | $59.34 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 15 | 13 | $42.81 |
| 90694 | 12 | 12 | $38.76 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 13 | 13 | $34.17 |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 13 | 13 | $28.10 |
| 96523 | 22 | 12 | $27.84 | |
| G0008 | Administration of influenza virus vaccine | 280 | 279 | $25.28 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 15 | 12 | $20.90 |
| 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 | 45 | 37 | $20.61 |
| 90700 | 519 | 492 | $14.54 | |
| G0379 | Direct admission of patient for hospital observation care | 89 | 86 | $10.85 |
| J2004 | Injection, lidocaine hcl with epinephrine, 1 mg | 12 | 12 | $9.94 |
| J7999 | Compounded drug, not otherwise classified | 489 | 265 | $0.03 |
| 91305 | 373 | 327 | $0.00 | |
| 90696 | 537 | 525 | $0.00 | |
| 91307 | 35 | 32 | $0.00 | |
| 96161 | 27 | 12 | $0.00 | |
| 91300 | 325 | 252 | $0.00 | |
| 91312 | 190 | 187 | $0.00 | |
| J7510 | Prednisolone oral, per 5 mg | 13 | 13 | $0.00 |
| 90685 | 53 | 53 | $0.00 | |
| J0171 | Injection, adrenalin, epinephrine, 0.1 mg | 23 | 12 | $0.00 |