NPI: 1801826912 · BIG STONE GAP, VA 24219 · General Acute Care Hospital · NPI assigned 07/04/2006
Authorized official HILTON, SHANE controls 20+ related entities in our dataset. Read more
| Authorized Official | HILTON, SHANE (EVP/CFO) |
| NPI Enumeration Date | 07/04/2006 |
Other providers sharing the same authorized official: HILTON, SHANE
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 100,763 | $2.40M |
| 2019 | 125,379 | $3.20M |
| 2020 | 59,656 | $2.09M |
| 2021 | 172,830 | $6.07M |
| 2022 | 158,107 | $6.29M |
| 2023 | 164,208 | $7.49M |
| 2024 | 112,690 | $6.17M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99284 | Emergency department visit for the evaluation and management, high severity | 39,312 | 33,666 | $6.36M |
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 24,763 | 21,287 | $3.28M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 20,578 | 17,297 | $2.98M |
| 96361 | Intravenous infusion, hydration; each additional hour | 10,266 | 7,932 | $2.64M |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 6,702 | 5,930 | $1.31M |
| 70450 | Computed tomography, head or brain; without contrast material | 6,697 | 5,740 | $1.06M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 7,980 | 7,200 | $970K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 4,215 | 3,700 | $836K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 14,526 | 12,955 | $797K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 3,299 | 2,197 | $726K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2,456 | 2,198 | $704K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 5,969 | 3,019 | $687K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 16,032 | 3,695 | $626K |
| 64493 | 624 | 510 | $530K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 6,691 | 4,919 | $529K |
| G0378 | Hospital observation service, per hour | 3,868 | 2,832 | $470K |
| 62323 | 940 | 831 | $424K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 9,877 | 8,158 | $416K |
| 64635 | 336 | 248 | $356K | |
| 27096 | 523 | 506 | $323K | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 1,742 | 1,617 | $294K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 2,700 | 2,300 | $289K |
| 78815 | Positron emission tomography (PET) for limited area imaging | 360 | 326 | $273K |
| 71275 | Computed tomographic angiography, chest, with contrast material | 1,236 | 1,118 | $266K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 594 | 540 | $250K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 5,121 | 3,844 | $223K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 2,704 | 1,953 | $222K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 1,076 | 920 | $220K |
| J2505 | Injection, pegfilgrastim, 6 mg | 114 | 64 | $205K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 1,924 | 1,766 | $182K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 3,618 | 3,454 | $176K |
| 80053 | Comprehensive metabolic panel | 42,557 | 34,258 | $173K |
| 76536 | 1,635 | 1,513 | $160K | |
| 97162 | 1,638 | 1,470 | $152K | |
| 96415 | 992 | 583 | $151K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 785 | 737 | $150K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 475 | 447 | $143K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 1,773 | 1,547 | $132K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 1,462 | 1,299 | $132K |
| 71046 | Radiologic examination, chest; 2 views | 8,303 | 7,440 | $118K |
| J2469 | Injection, palonosetron hcl, 25 mcg | 1,813 | 911 | $117K |
| J9271 | Injection, pembrolizumab, 1 mg | 15 | 14 | $113K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 244 | 215 | $113K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 970 | 900 | $108K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 109 | 105 | $93K |
| 93971 | 1,050 | 917 | $91K | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 5,747 | 1,518 | $90K |
| 95886 | 723 | 695 | $89K | |
| 71250 | 1,610 | 1,409 | $88K | |
| 96523 | 1,761 | 1,448 | $86K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 542 | 515 | $77K |
| 72141 | 422 | 401 | $77K | |
| P9016 | Red blood cells, leukocytes reduced, each unit | 274 | 177 | $72K |
| 77412 | 392 | 36 | $71K | |
| 36591 | 2,506 | 1,899 | $68K | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 351 | 76 | $66K |
| 29581 | 450 | 145 | $66K | |
| 12001 | 350 | 319 | $65K | |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 681 | 515 | $61K |
| 76641 | 530 | 472 | $55K | |
| 87040 | 9,478 | 4,645 | $53K | |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 465 | 240 | $52K |
| J1453 | Injection, fosaprepitant, 1 mg | 650 | 348 | $51K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 22,468 | 17,341 | $48K |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | 632 | 602 | $48K |
| 73221 | 278 | 253 | $47K | |
| 84443 | Thyroid stimulating hormone (TSH) | 8,166 | 7,374 | $47K |
| 74018 | 2,833 | 2,550 | $47K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 47,721 | 37,268 | $46K |
| 83880 | 5,963 | 4,871 | $46K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 20,052 | 16,242 | $45K |
| 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 | 5,161 | 4,247 | $44K |
| 72125 | Computed tomography, cervical spine; without contrast material | 2,051 | 1,789 | $44K |
| J0897 | Injection, denosumab, 1 mg | 104 | 95 | $43K |
| 36415 | Collection of venous blood by venipuncture | 38,241 | 28,607 | $43K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 13,640 | 11,850 | $43K |
| 73562 | 2,944 | 2,598 | $42K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 14,111 | 10,697 | $42K |
| 80048 | Basic metabolic panel (calcium, ionized) | 11,322 | 8,716 | $41K |
| 47562 | 12 | 12 | $41K | |
| 72100 | 2,195 | 2,007 | $38K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 70 | 65 | $37K |
| 36430 | 397 | 246 | $34K | |
| 71271 | 358 | 350 | $34K | |
| 77336 | 653 | 244 | $33K | |
| 95811 | 75 | 69 | $33K | |
| 93017 | 337 | 305 | $29K | |
| 71045 | Radiologic examination, chest; single view | 14,980 | 12,381 | $28K |
| 73030 | 2,336 | 2,041 | $28K | |
| 73630 | 2,725 | 2,448 | $25K | |
| 73610 | 2,242 | 2,050 | $22K | |
| 90715 | 1,160 | 1,076 | $21K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 111 | 101 | $21K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 1,501 | 1,414 | $20K |
| 70496 | 74 | 64 | $19K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 599 | 171 | $18K |
| 84484 | 17,432 | 11,994 | $18K | |
| 83036 | Hemoglobin; glycosylated (A1C) | 3,944 | 3,658 | $17K |
| 95806 | 25 | 24 | $17K | |
| 80061 | Lipid panel | 3,307 | 3,042 | $16K |
| 70486 | 401 | 350 | $16K | |
| 73130 | 1,920 | 1,723 | $16K | |
| 97014 | 513 | 170 | $14K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 883 | 253 | $14K |
| 87086 | Culture, bacterial; quantitative colony count, urine | 7,691 | 6,655 | $13K |
| 96416 | 43 | 24 | $13K | |
| 85379 | 3,048 | 2,682 | $13K | |
| 59025 | Fetal non-stress test | 66 | 54 | $13K |
| 85027 | 5,730 | 4,760 | $13K | |
| J7030 | Infusion, normal saline solution , 1000 cc | 6,827 | 5,248 | $12K |
| 97035 | 544 | 149 | $12K | |
| 73502 | 1,154 | 994 | $12K | |
| 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 | 803 | 699 | $12K |
| 72131 | 301 | 273 | $12K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 12 | 12 | $12K |
| 80074 | 940 | 883 | $12K | |
| 97597 | 113 | 78 | $11K | |
| 74178 | 54 | 49 | $11K | |
| 73110 | 1,265 | 1,141 | $11K | |
| 96375 | Therapeutic injection; each additional sequential IV push | 16,411 | 11,610 | $11K |
| 84702 | 2,142 | 1,678 | $11K | |
| 29125 | 58 | 52 | $10K | |
| 64494 | 640 | 507 | $10K | |
| 62321 | 12 | 12 | $10K | |
| 84439 | 2,574 | 2,355 | $10K | |
| 81001 | 18,403 | 15,340 | $9K | |
| 70491 | 59 | 53 | $9K | |
| 81025 | 9,203 | 8,105 | $9K | |
| 97161 | 52 | 52 | $8K | |
| 94729 | 301 | 286 | $8K | |
| 84481 | 691 | 647 | $8K | |
| 64636 | 38 | 24 | $8K | |
| 83605 | 10,201 | 7,491 | $8K | |
| 0001A | 279 | 254 | $7K | |
| 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 | 30 | 27 | $7K |
| 76830 | Ultrasound, transvaginal | 70 | 67 | $7K |
| 86592 | 1,125 | 1,052 | $7K | |
| 93970 | 73 | 65 | $7K | |
| 72040 | 225 | 210 | $7K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 1,166 | 1,107 | $7K |
| 81003 | 11,791 | 10,203 | $7K | |
| 0002A | 215 | 196 | $7K | |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 75 | 65 | $6K |
| 93246 | 168 | 164 | $6K | |
| 82670 | 443 | 423 | $6K | |
| 96417 | 818 | 412 | $6K | |
| 87186 | 3,609 | 3,072 | $5K | |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 42 | 37 | $5K |
| 94726 | 137 | 129 | $5K | |
| 82607 | 979 | 920 | $5K | |
| 76000 | 153 | 134 | $5K | |
| 72110 | 124 | 115 | $5K | |
| 84403 | 393 | 373 | $4K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 968 | 826 | $4K |
| 94060 | 87 | 81 | $4K | |
| 83001 | 511 | 489 | $4K | |
| 84146 | 481 | 454 | $4K | |
| 72050 | 160 | 151 | $4K | |
| 73080 | 539 | 472 | $4K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 42 | 41 | $4K |
| J7050 | Infusion, normal saline solution, 250 cc | 3,230 | 1,415 | $4K |
| 80143 | 1,104 | 932 | $4K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 484 | 448 | $4K |
| 83002 | 506 | 484 | $4K | |
| 97163 | 90 | 83 | $4K | |
| 77080 | 59 | 59 | $4K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 8,613 | 4,369 | $4K |
| 86850 | 1,956 | 1,626 | $4K | |
| 95913 | 66 | 63 | $4K | |
| 29515 | 13 | 13 | $3K | |
| 86901 | 2,339 | 1,940 | $3K | |
| 96376 | 4,729 | 3,078 | $3K | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 13,339 | 10,572 | $3K |
| 36600 | 2,567 | 1,951 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1,275 | 1,120 | $3K |
| 96367 | 3,451 | 1,883 | $3K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 201 | 186 | $3K |
| 82728 | 450 | 408 | $3K | |
| 83735 | 9,926 | 7,923 | $3K | |
| A9585 | Injection, gadobutrol, 0.1 ml | 1,465 | 1,330 | $3K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 8,724 | 6,459 | $3K |
| 83655 | 226 | 223 | $3K | |
| 72072 | 185 | 166 | $3K | |
| 74174 | 12 | 12 | $2K | |
| 82565 | 1,308 | 1,098 | $2K | |
| 87077 | 3,448 | 2,938 | $2K | |
| 87070 | 1,583 | 1,310 | $2K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 16 | 13 | $2K |
| 86762 | 347 | 324 | $2K | |
| 12002 | 12 | 12 | $2K | |
| 86140 | 1,188 | 1,055 | $2K | |
| 80076 | 740 | 637 | $2K | |
| 73590 | 343 | 308 | $2K | |
| 10060 | 44 | 37 | $2K | |
| 93880 | 30 | 25 | $2K | |
| 82570 | 731 | 645 | $2K | |
| 76870 | 16 | 14 | $2K | |
| J8540 | Dexamethasone, oral, 0.25 mg | 1,750 | 842 | $2K |
| 83525 | 282 | 268 | $2K | |
| 87081 | 5,552 | 5,094 | $2K | |
| 85018 | 538 | 457 | $2K | |
| 74022 | 523 | 467 | $2K | |
| 80179 | 1,063 | 913 | $2K | |
| 85652 | 1,445 | 1,257 | $2K | |
| 85610 | 3,624 | 2,925 | $2K | |
| 82950 | 376 | 365 | $2K | |
| 83690 | 11,231 | 9,405 | $2K | |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 8,494 | 4,224 | $2K |
| 86900 | 2,330 | 1,929 | $2K | |
| 95910 | 12 | 12 | $2K | |
| 77280 | 16 | 13 | $2K | |
| 83550 | 328 | 302 | $2K | |
| 83540 | 495 | 455 | $1K | |
| 93242 | 26 | 25 | $1K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 10,266 | 8,495 | $1K |
| 94664 | 1,081 | 850 | $1K | |
| 70498 | 46 | 38 | $1K | |
| 71101 | 141 | 122 | $965.47 | |
| 82140 | 1,454 | 1,164 | $951.94 | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 483 | 447 | $912.53 |
| 83050 | 623 | 505 | $904.38 | |
| 87205 | 1,435 | 1,118 | $904.21 | |
| 64495 | 128 | 106 | $852.53 | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 3,584 | 3,348 | $785.73 |
| 95912 | 14 | 14 | $781.80 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 1,326 | 1,175 | $772.21 |
| 84703 | 2,898 | 2,615 | $756.16 | |
| 82803 | 2,061 | 1,477 | $721.58 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 5,845 | 5,358 | $720.66 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 1,768 | 1,135 | $671.60 |
| 77065 | Tomosynthesis, mammo | 14 | 12 | $651.48 |
| 84100 | 1,202 | 907 | $618.11 | |
| 73090 | 158 | 137 | $609.93 | |
| 82043 | 292 | 267 | $584.61 | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 2,556 | 1,999 | $579.42 |
| 85730 | 1,751 | 1,474 | $577.57 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 5,540 | 4,277 | $569.99 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 3,465 | 2,561 | $550.54 |
| 72128 | 28 | 25 | $527.53 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 3,712 | 2,726 | $513.68 |
| 84520 | 414 | 338 | $512.61 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1,570 | 1,422 | $505.29 |
| 94727 | 29 | 25 | $503.07 | |
| Q9950 | Injection, sulfur hexafluoride lipid microspheres, per ml | 32 | 28 | $480.90 |
| 77066 | Tomosynthesis, mammo | 16 | 12 | $470.68 |
| 82166 | 26 | 24 | $469.49 | |
| 85007 | 1,756 | 1,438 | $413.96 | |
| J3480 | Injection, potassium chloride, per 2 meq | 1,161 | 655 | $409.80 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 3,559 | 3,086 | $398.26 |
| J2060 | Injection, lorazepam, 2 mg | 1,035 | 779 | $347.03 |
| 84156 | 143 | 118 | $341.09 | |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 1,421 | 1,238 | $320.72 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 1,140 | 806 | $311.03 |
| J3490 | Unclassified drugs | 2,340 | 1,394 | $291.93 |
| 84112 | 18 | 15 | $280.24 | |
| 84550 | 205 | 179 | $279.49 | |
| 82550 | 563 | 476 | $275.21 | |
| C9113 | Injection, pantoprazole sodium, per vial | 1,566 | 1,051 | $274.48 |
| 82150 | 1,419 | 1,226 | $253.52 | |
| J0690 | Injection, cefazolin sodium, 500 mg | 1,708 | 1,448 | $251.37 |
| J1756 | Injection, iron sucrose, 1 mg | 475 | 181 | $251.02 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 4,279 | 3,456 | $249.28 |
| 94761 | 3,667 | 2,748 | $234.25 | |
| 94762 | 43 | 31 | $232.72 | |
| 87641 | 91 | 83 | $221.20 | |
| J1170 | Injection, hydromorphone, up to 4 mg | 1,999 | 1,423 | $220.05 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | 1,111 | 913 | $205.82 |
| J1940 | Injection, furosemide, up to 20 mg | 562 | 349 | $205.74 |
| 82805 | 615 | 497 | $195.80 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | 468 | 417 | $185.27 |
| J1650 | Injection, enoxaparin sodium, 10 mg | 1,041 | 661 | $184.11 |
| J7120 | Ringers lactate infusion, up to 1000 cc | 1,882 | 1,505 | $179.69 |
| 96368 | 634 | 396 | $175.29 | |
| 0011A | 29 | 25 | $158.57 | |
| J3475 | Injection, magnesium sulfate, per 500 mg | 1,206 | 838 | $143.10 |
| 80320 | 272 | 239 | $127.34 | |
| 51702 | 14 | 12 | $117.95 | |
| 82272 | 314 | 274 | $111.30 | |
| J0780 | Injection, prochlorperazine, up to 10 mg | 1,371 | 1,156 | $102.22 |
| J3370 | Injection, vancomycin hcl, 500 mg | 717 | 340 | $96.31 |
| 87209 | 15 | 15 | $95.43 | |
| J2785 | Injection, regadenoson, 0.1 mg | 168 | 144 | $93.26 |
| 73552 | 17 | 14 | $85.78 | |
| 86038 | 14 | 12 | $82.79 | |
| 94760 | 1,770 | 1,386 | $81.28 | |
| 82375 | 617 | 500 | $79.34 | |
| 87210 | 57 | 55 | $73.80 | |
| 87807 | 468 | 443 | $71.87 | |
| J9190 | Injection, fluorouracil, 500 mg | 119 | 24 | $71.16 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 908 | 776 | $62.60 |
| 87177 | 15 | 15 | $58.20 | |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 48 | 39 | $57.28 |
| J1644 | Injection, heparin sodium, per 1000 units | 348 | 205 | $55.01 |
| J1815 | Injection, insulin, per 5 units | 756 | 361 | $47.36 |
| J2550 | Injection, promethazine hcl, up to 50 mg | 565 | 443 | $39.95 |
| J2780 | Injection, ranitidine hydrochloride, 25 mg | 259 | 88 | $32.12 |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 609 | 216 | $31.75 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 259 | 223 | $26.37 |
| J2704 | Injection, propofol, 10 mg | 3,310 | 2,887 | $25.90 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 757 | 658 | $22.43 |
| J2471 | Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg | 108 | 86 | $19.58 |
| 82010 | 117 | 95 | $17.99 | |
| 86308 | 59 | 54 | $16.31 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 265 | 115 | $15.80 |
| 88312 | 468 | 433 | $14.24 | |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 247 | 217 | $6.77 |
| J2175 | Injection, meperidine hydrochloride, per 100 mg | 185 | 128 | $6.63 |
| J0171 | Injection, adrenalin, epinephrine, 0.1 mg | 80 | 54 | $5.90 |
| J7510 | Prednisolone oral, per 5 mg | 79 | 75 | $4.99 |
| J1020 | Injection, methylprednisolone acetate, 20 mg | 69 | 57 | $2.74 |
| 88304 | 308 | 283 | $1.97 | |
| J0456 | Injection, azithromycin, 500 mg | 31 | 24 | $1.58 |
| J1956 | Injection, levofloxacin, 250 mg | 33 | 27 | $1.42 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 254 | 206 | $1.28 |
| A9270 | Non-covered item or service | 7,176 | 1,899 | $0.59 |
| 96377 | 42 | 24 | $0.00 | |
| 76801 | 50 | 40 | $0.00 | |
| 96411 | 23 | 14 | $0.00 | |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 613 | 508 | $0.00 |
| J1171 | Injection, hydromorphone, 0.1 mg | 97 | 78 | $0.00 |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 382 | 346 | $0.00 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 392 | 294 | $0.00 |
| A9537 | Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries | 30 | 26 | $0.00 |
| J0692 | Injection, cefepime hydrochloride, 500 mg | 56 | 41 | $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 | 19 | 14 | $0.00 |
| J0737 | Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg | 23 | 21 | $0.00 |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | 34 | 22 | $0.00 |
| G8978 | Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals | 19 | 14 | $0.00 |