NPI: 1871606921 · DOVER, OH 44622 · Rural Acute Care Hospital · NPI assigned 08/15/2006
Authorized official LARAWAY, DENNIS controls 20+ related entities in our dataset. Read more
| Authorized Official | LARAWAY, DENNIS (EXECUTIVE VP CHIEF FINANCE OFFICER) |
| NPI Enumeration Date | 08/15/2006 |
Other providers sharing the same authorized official: LARAWAY, DENNIS
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 74,920 | $2.17M |
| 2019 | 67,301 | $2.06M |
| 2020 | 45,215 | $1.93M |
| 2021 | 42,974 | $1.67M |
| 2022 | 78,215 | $2.70M |
| 2023 | 159,136 | $5.21M |
| 2024 | 130,357 | $4.48M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 45,415 | 32,861 | $3.36M |
| 99284 | Emergency department visit for the evaluation and management, high severity | 42,882 | 31,355 | $3.23M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 28,172 | 19,495 | $2.85M |
| 96361 | Intravenous infusion, hydration; each additional hour | 4,201 | 2,988 | $1.13M |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 12,209 | 3,030 | $811K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 13,832 | 9,936 | $617K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 2,275 | 1,828 | $540K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 9,655 | 8,185 | $517K |
| 59025 | Fetal non-stress test | 3,852 | 1,590 | $473K |
| 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 | 4,279 | 3,672 | $463K |
| 70450 | Computed tomography, head or brain; without contrast material | 2,171 | 1,828 | $444K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6,891 | 6,531 | $327K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 2,132 | 1,432 | $243K |
| 80053 | Comprehensive metabolic panel | 16,537 | 13,830 | $233K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | 902 | 760 | $223K |
| 80048 | Basic metabolic panel (calcium, ionized) | 26,233 | 21,676 | $208K |
| 87631 | 1,267 | 1,045 | $199K | |
| G0378 | Hospital observation service, per hour | 2,708 | 1,215 | $171K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 2,238 | 1,973 | $165K |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 901 | 727 | $157K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 910 | 481 | $153K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 3,582 | 3,234 | $139K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 1,636 | 546 | $133K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 1,652 | 998 | $127K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1,053 | 907 | $121K |
| 84443 | Thyroid stimulating hormone (TSH) | 6,860 | 6,192 | $119K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 43,563 | 36,079 | $111K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 953 | 714 | $104K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 527 | 467 | $97K |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | 319 | 247 | $92K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 3,579 | 3,232 | $86K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1,043 | 725 | $78K |
| 71046 | Radiologic examination, chest; 2 views | 5,856 | 5,237 | $74K |
| 87086 | Culture, bacterial; quantitative colony count, urine | 7,086 | 5,878 | $72K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 2,996 | 2,736 | $68K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 12,110 | 10,603 | $68K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 788 | 652 | $65K |
| 80061 | Lipid panel | 5,637 | 5,187 | $64K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 755 | 649 | $60K |
| 36415 | Collection of venous blood by venipuncture | 54,078 | 42,400 | $53K |
| 84439 | 2,276 | 2,090 | $51K | |
| 97161 | 921 | 830 | $51K | |
| 99215 | Prolong outpt/office vis | 530 | 499 | $50K |
| 71275 | Computed tomographic angiography, chest, with contrast material | 251 | 205 | $49K |
| 76770 | 385 | 352 | $49K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 2,709 | 2,258 | $48K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 1,513 | 511 | $48K |
| 77063 | Screening digital breast tomosynthesis, bilateral | 976 | 895 | $46K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 255 | 210 | $44K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1,617 | 1,417 | $43K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 14,057 | 11,619 | $43K |
| 71250 | 411 | 387 | $41K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 245 | 226 | $40K |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 2,121 | 1,970 | $39K |
| 83036 | Hemoglobin; glycosylated (A1C) | 3,112 | 2,819 | $37K |
| 97162 | 900 | 769 | $37K | |
| 81513 | 235 | 193 | $34K | |
| 87070 | 2,362 | 1,996 | $33K | |
| 76830 | Ultrasound, transvaginal | 501 | 436 | $32K |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 335 | 322 | $30K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 105 | 89 | $30K |
| 80076 | 8,018 | 6,644 | $27K | |
| 82607 | 1,230 | 1,084 | $26K | |
| 93017 | 390 | 311 | $25K | |
| 86850 | 1,206 | 976 | $25K | |
| 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 | 4,235 | 3,622 | $25K |
| 93971 | 567 | 486 | $25K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1,540 | 1,353 | $22K |
| 71045 | Radiologic examination, chest; single view | 5,817 | 4,905 | $21K |
| 85027 | 3,793 | 3,075 | $19K | |
| 76819 | Fetal biophysical profile; without non-stress testing | 200 | 106 | $19K |
| 74018 | 713 | 611 | $19K | |
| 82728 | 1,062 | 919 | $19K | |
| 84484 | 8,929 | 5,278 | $18K | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 435 | 381 | $18K |
| 86900 | 1,402 | 1,132 | $18K | |
| 72100 | 650 | 576 | $17K | |
| 95886 | 62 | 46 | $17K | |
| 84702 | 1,117 | 756 | $17K | |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 254 | 221 | $15K |
| 86592 | 419 | 350 | $15K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | 461 | 213 | $14K |
| 86803 | 755 | 626 | $14K | |
| 87481 | 567 | 471 | $14K | |
| 93975 | 144 | 122 | $13K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1,232 | 1,007 | $13K |
| 83540 | 1,291 | 1,115 | $13K | |
| 86703 | 629 | 560 | $13K | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | 679 | 570 | $12K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 34 | 25 | $12K |
| 86140 | 900 | 740 | $12K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 110 | 103 | $12K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 980 | 899 | $12K |
| 83550 | 1,218 | 1,048 | $11K | |
| 70496 | 80 | 69 | $11K | |
| 70498 | 98 | 81 | $11K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 327 | 225 | $11K |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | 358 | 307 | $11K |
| 82570 | 1,230 | 1,058 | $11K | |
| 76818 | 157 | 53 | $11K | |
| 0002A | 327 | 314 | $11K | |
| 86780 | 433 | 347 | $10K | |
| 87077 | 1,249 | 1,030 | $10K | |
| 76536 | 93 | 89 | $10K | |
| 76642 | 89 | 84 | $10K | |
| 73630 | 615 | 500 | $9K | |
| 0001A | 372 | 315 | $9K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 321 | 203 | $9K |
| 84481 | 565 | 516 | $9K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1,295 | 1,133 | $9K |
| 81001 | 8,967 | 7,528 | $9K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 81 | 78 | $9K |
| 96367 | 260 | 208 | $8K | |
| 87340 | 438 | 364 | $8K | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 948 | 829 | $8K |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 43 | 43 | $8K |
| 82950 | 595 | 527 | $8K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 33 | 32 | $8K |
| 81003 | 6,446 | 5,553 | $8K | |
| 86901 | 1,402 | 1,132 | $7K | |
| 72125 | Computed tomography, cervical spine; without contrast material | 807 | 704 | $7K |
| 73030 | 455 | 392 | $7K | |
| 83735 | 2,745 | 2,010 | $7K | |
| 86787 | 366 | 289 | $7K | |
| 83880 | 2,029 | 1,652 | $6K | |
| 86038 | 197 | 160 | $6K | |
| 85610 | 3,299 | 2,119 | $6K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2,731 | 1,975 | $6K |
| 84153 | 378 | 349 | $6K | |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 26 | 26 | $6K |
| 93970 | 48 | 46 | $5K | |
| 86762 | 163 | 118 | $5K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 338 | 266 | $5K |
| 97116 | 372 | 197 | $5K | |
| 82746 | 427 | 378 | $5K | |
| 73502 | 306 | 259 | $5K | |
| 87186 | 921 | 755 | $5K | |
| 82043 | 675 | 608 | $5K | |
| 80055 | 149 | 130 | $5K | |
| 71271 | 29 | 28 | $4K | |
| 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 | 117 | 113 | $4K |
| 97113 | 44 | 14 | $4K | |
| 83690 | 4,761 | 3,784 | $4K | |
| 87653 | 194 | 176 | $4K | |
| 97802 | 87 | 74 | $4K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 28 | 28 | $4K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 137 | 117 | $4K |
| 76801 | 84 | 69 | $4K | |
| 97535 | Self-care/home management training, each 15 minutes | 179 | 149 | $4K |
| 73610 | 524 | 434 | $4K | |
| 82805 | 423 | 351 | $4K | |
| 76857 | 111 | 92 | $4K | |
| 99406 | 184 | 170 | $4K | |
| 73130 | 354 | 299 | $4K | |
| 94060 | 29 | 27 | $3K | |
| 82553 | 568 | 444 | $3K | |
| 83001 | 147 | 128 | $3K | |
| 84403 | 150 | 133 | $3K | |
| 90715 | 249 | 207 | $3K | |
| 84112 | 65 | 52 | $3K | |
| 94010 | 136 | 124 | $3K | |
| 93880 | 47 | 45 | $3K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 9,299 | 7,690 | $3K |
| 72070 | 89 | 84 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 642 | 613 | $3K |
| 83605 | 2,083 | 1,508 | $3K | |
| 88142 | 149 | 142 | $3K | |
| 73560 | 196 | 166 | $2K | |
| 85651 | 429 | 344 | $2K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 12 | 12 | $2K |
| 83970 | 80 | 76 | $2K | |
| 72050 | 42 | 40 | $2K | |
| 96376 | 1,217 | 770 | $2K | |
| 83615 | 222 | 157 | $2K | |
| 84703 | 2,049 | 1,585 | $2K | |
| 70486 | 12 | 12 | $2K | |
| 81025 | 2,401 | 1,909 | $2K | |
| 87505 | 13 | 13 | $2K | |
| 96375 | Therapeutic injection; each additional sequential IV push | 3,943 | 3,024 | $2K |
| 82962 | 1,912 | 743 | $2K | |
| 84156 | 416 | 327 | $2K | |
| 80069 | 78 | 58 | $2K | |
| 86618 | 78 | 50 | $2K | |
| 73110 | 221 | 196 | $2K | |
| 82550 | 1,355 | 1,095 | $2K | |
| 86431 | 92 | 69 | $2K | |
| 82784 | 113 | 72 | $2K | |
| 94729 | 33 | 29 | $1K | |
| 87205 | 324 | 244 | $1K | |
| 94726 | 30 | 26 | $1K | |
| 82565 | 147 | 116 | $1K | |
| J1756 | Injection, iron sucrose, 1 mg | 30 | 12 | $1K |
| 87040 | 952 | 715 | $1K | |
| 85379 | 894 | 744 | $1K | |
| 84550 | 144 | 118 | $1K | |
| 72040 | 47 | 40 | $1K | |
| 85730 | 1,277 | 998 | $1K | |
| 80321 | 89 | 84 | $1K | |
| 73564 | 206 | 183 | $1K | |
| 80320 | 586 | 436 | $1K | |
| 82077 | 617 | 522 | $1K | |
| 88141 | 52 | 52 | $1K | |
| 83516 | 47 | 30 | $1K | |
| 97165 | 14 | 13 | $986.85 | |
| 87081 | 67 | 66 | $979.48 | |
| 00811 | 211 | 156 | $948.99 | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 612 | 573 | $942.53 |
| 83002 | 61 | 51 | $942.13 | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 52 | 26 | $788.84 |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 15 | 12 | $707.18 |
| 84450 | 88 | 68 | $695.87 | |
| 84460 | 109 | 87 | $681.44 | |
| 85652 | 285 | 264 | $680.40 | |
| 86706 | 38 | 30 | $673.82 | |
| A9270 | Non-covered item or service | 5,009 | 869 | $593.57 |
| 82150 | 197 | 165 | $591.61 | |
| 80373 | 89 | 84 | $578.36 | |
| 80369 | 89 | 84 | $578.36 | |
| 80372 | 89 | 84 | $573.27 | |
| 84146 | 26 | 14 | $548.67 | |
| 96368 | 59 | 40 | $523.19 | |
| 82330 | 498 | 385 | $514.94 | |
| 85018 | 519 | 427 | $464.86 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 203 | 145 | $454.04 |
| 84100 | 316 | 233 | $438.46 | |
| 80329 | 443 | 340 | $437.35 | |
| 82677 | 12 | 12 | $418.02 | |
| 80324 | 89 | 84 | $408.15 | |
| 82803 | 184 | 131 | $397.70 | |
| 80345 | 89 | 84 | $397.35 | |
| 80346 | 89 | 84 | $397.35 | |
| 80348 | 89 | 84 | $397.35 | |
| 82670 | 12 | 12 | $380.42 | |
| 80349 | 89 | 84 | $374.81 | |
| 80359 | 89 | 84 | $374.81 | |
| 80353 | 89 | 84 | $374.81 | |
| 80358 | 89 | 84 | $374.81 | |
| 80361 | 89 | 84 | $374.81 | |
| 80356 | 89 | 84 | $374.81 | |
| 80354 | 89 | 84 | $374.81 | |
| 80365 | 89 | 84 | $374.81 | |
| 82947 | 449 | 377 | $331.68 | |
| 73140 | 30 | 25 | $313.93 | |
| 84132 | 496 | 406 | $300.25 | |
| 36600 | 132 | 103 | $299.54 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | 1,336 | 970 | $295.06 |
| 82105 | 12 | 12 | $287.08 | |
| 82435 | 431 | 361 | $229.86 | |
| 82375 | 452 | 375 | $228.40 | |
| 88342 | 52 | 41 | $217.14 | |
| 93016 | 15 | 14 | $205.05 | |
| 85014 | 16 | 12 | $191.05 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | 274 | 128 | $186.88 |
| 80305 | 159 | 150 | $182.22 | |
| 73590 | 15 | 12 | $169.55 | |
| J7030 | Infusion, normal saline solution , 1000 cc | 2,948 | 2,187 | $155.37 |
| 86336 | 12 | 12 | $143.54 | |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 178 | 105 | $129.97 |
| 93018 | 15 | 14 | $119.97 | |
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 256 | 236 | $117.50 |
| 84311 | 76 | 71 | $115.70 | |
| 83050 | 442 | 365 | $114.91 | |
| 84295 | 436 | 365 | $114.91 | |
| J1815 | Injection, insulin, per 5 units | 67 | 39 | $108.00 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 6,171 | 4,397 | $106.30 |
| J1170 | Injection, hydromorphone, up to 4 mg | 498 | 341 | $88.50 |
| J3490 | Unclassified drugs | 27 | 23 | $86.97 |
| 84520 | 12 | 12 | $74.85 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 2,355 | 1,739 | $72.41 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 905 | 680 | $69.88 |
| 80143 | 90 | 84 | $66.66 | |
| 71101 | 12 | 12 | $65.62 | |
| 83986 | 76 | 71 | $50.72 | |
| J3370 | Injection, vancomycin hcl, 500 mg | 152 | 84 | $46.32 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 654 | 425 | $45.76 |
| 93799 | 40 | 17 | $31.13 | |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 251 | 175 | $28.07 |
| 95909 | 12 | 12 | $27.73 | |
| J2060 | Injection, lorazepam, 2 mg | 261 | 203 | $23.16 |
| J2704 | Injection, propofol, 10 mg | 1,116 | 921 | $14.80 |
| 82140 | 13 | 13 | $13.62 | |
| J1790 | Injection, droperidol, up to 5 mg | 212 | 160 | $13.04 |
| 80179 | 49 | 44 | $11.11 | |
| 87088 | 16 | 15 | $9.62 | |
| J1644 | Injection, heparin sodium, per 1000 units | 217 | 95 | $8.89 |
| J7050 | Infusion, normal saline solution, 250 cc | 335 | 213 | $8.46 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 1,072 | 715 | $8.20 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 247 | 211 | $8.04 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 382 | 318 | $7.82 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 3,878 | 3,167 | $6.00 |
| 91300 | 704 | 520 | $5.36 | |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 215 | 139 | $4.82 |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 59 | 41 | $4.67 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 236 | 176 | $4.40 |
| J1171 | Injection, hydromorphone, 0.1 mg | 77 | 58 | $4.05 |
| J0690 | Injection, cefazolin sodium, 500 mg | 437 | 326 | $3.28 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 616 | 501 | $2.14 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 655 | 544 | $1.58 |
| J2785 | Injection, regadenoson, 0.1 mg | 132 | 95 | $0.00 |
| 94760 | 915 | 545 | $0.00 | |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 193 | 136 | $0.00 |
| 73090 | 16 | 15 | $0.00 | |
| 88304 | 90 | 68 | $0.00 | |
| 00813 | 13 | 13 | $0.00 | |
| 74022 | 18 | 13 | $0.00 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 24 | 24 | $0.00 |
| 00731 | 65 | 55 | $0.00 | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 137 | 104 | $0.00 |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 132 | 118 | $0.00 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 224 | 186 | $0.00 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 125 | 112 | $0.00 |
| J3475 | Injection, magnesium sulfate, per 500 mg | 123 | 97 | $0.00 |
| J2550 | Injection, promethazine hcl, up to 50 mg | 15 | 13 | $0.00 |
| 76942 | 33 | 27 | $0.00 | |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 18 | 12 | $0.00 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 19 | 17 | $0.00 |