Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

GOOD SAMARITAN HOSPITAL MEDICAL CENTER

NPI: 1902865355 · WEST ISLIP, NY 11795 · Hearing and Speech Clinic/Center · NPI assigned 03/22/2006

$63.30M
Total Medicaid Paid
1,416,096
Total Claims
1,254,198
Beneficiaries
409
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialALLISON, WILLIAM (CHIEF FINANCIAL OFFICER)
NPI Enumeration Date03/22/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 29,465 $1.12M
2019 83,677 $3.41M
2020 185,986 $7.86M
2021 262,286 $11.06M
2022 282,941 $12.81M
2023 314,953 $14.58M
2024 256,788 $12.46M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 64,776 58,869 $7.97M
99284 Emergency department visit for the evaluation and management, high severity 33,895 32,521 $5.15M
99283 Emergency department visit for the evaluation and management, moderate severity 32,838 31,425 $5.04M
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 30,019 28,321 $4.43M
96361 Intravenous infusion, hydration; each additional hour 21,748 17,809 $4.08M
G0378 Hospital observation service, per hour 8,202 7,763 $2.96M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 11,027 8,699 $1.71M
70450 Computed tomography, head or brain; without contrast material 7,935 7,596 $1.68M
99282 Emergency department visit for the evaluation and management, low to moderate severity 10,796 10,449 $1.66M
74177 Computed tomography, abdomen and pelvis; with contrast material 7,952 7,727 $1.60M
93975 3,352 3,190 $1.54M
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 8,952 8,511 $1.50M
76700 Ultrasound, abdominal, real time with image documentation; complete 3,417 3,378 $1.43M
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,942 1,936 $1.33M
95810 Polysomnography; sleep staging with 4 or more additional parameters 1,211 1,209 $942K
80053 Comprehensive metabolic panel 54,013 49,448 $883K
97530 Therapeutic activities, direct patient contact, each 15 minutes 7,100 2,328 $710K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 1,639 1,595 $660K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 5,258 1,575 $634K
93970 1,213 1,180 $617K
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 7,950 7,727 $592K
36415 Collection of venous blood by venipuncture 91,878 66,332 $578K
0202U Oncology (prostate), multianalyte, gene expression profiling 15,008 14,658 $573K
71275 Computed tomographic angiography, chest, with contrast material 2,309 2,270 $536K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3,824 3,678 $501K
86850 19,550 18,482 $463K
95782 513 511 $430K
76770 1,378 1,360 $417K
86900 19,761 18,680 $413K
80048 Basic metabolic panel (calcium, ionized) 25,716 23,685 $412K
70551 Magnetic resonance imaging, brain; without contrast material 1,442 1,435 $392K
86901 19,757 18,674 $387K
74176 Computed tomography, abdomen and pelvis; without contrast material 1,781 1,734 $362K
96415 753 630 $339K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 7,119 2,444 $316K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 2,116 1,438 $315K
99281 Emergency department visit for the evaluation and management, self-limited or minor 1,967 1,864 $299K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 6,588 6,354 $289K
58558 231 230 $267K
51701 957 946 $262K
93458 145 144 $241K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 3,758 3,320 $218K
88305 Level IV - Surgical pathology, gross and microscopic examination 5,484 5,423 $215K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination 6,095 2,154 $191K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 1,947 1,476 $183K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 4,245 3,610 $176K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 6,605 6,589 $173K
12001 440 439 $169K
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 7,577 7,348 $168K
12011 421 421 $160K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 4,657 4,430 $151K
J3490 Unclassified drugs 7,118 5,226 $146K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 4,287 1,505 $145K
76818 3,380 1,451 $144K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 11,425 9,045 $125K
83880 4,896 4,574 $123K
80076 12,706 12,122 $122K
95816 913 909 $107K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 891 888 $106K
77067 Screening mammography, bilateral, including computer-aided detection 1,471 1,471 $105K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 1,969 1,422 $104K
J1756 Injection, iron sucrose, 1 mg 2,507 1,120 $102K
96367 1,523 1,322 $99K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 564 561 $96K
76830 Ultrasound, transvaginal 2,773 2,665 $95K
45380 Colonoscopy, flexible; with biopsy, single or multiple 131 129 $91K
80061 Lipid panel 13,362 13,289 $90K
87631 2,110 2,062 $90K
70496 387 382 $90K
J1439 Injection, ferric carboxymaltose, 1 mg 123 81 $88K
94010 1,940 1,826 $88K
97803 1,654 1,299 $87K
85610 24,376 22,757 $83K
64483 118 113 $83K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 65,789 59,178 $82K
84443 Thyroid stimulating hormone (TSH) 15,923 15,550 $81K
94060 400 394 $77K
83036 Hemoglobin; glycosylated (A1C) 10,940 10,874 $75K
76801 1,130 1,049 $75K
72131 1,100 1,057 $74K
J0248 Injection, remdesivir, 1 mg 155 70 $73K
97802 1,190 1,189 $73K
82607 5,992 5,963 $71K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 973 965 $70K
97116 1,754 820 $65K
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 1,691 1,675 $65K
82728 5,527 5,448 $61K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 164 160 $60K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 2,399 2,368 $60K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 14,400 13,599 $59K
76819 Fetal biophysical profile; without non-stress testing 1,387 1,227 $59K
84439 8,467 8,378 $58K
59025 Fetal non-stress test 765 673 $56K
96040 1,010 988 $54K
70544 161 151 $54K
76820 2,447 1,276 $53K
Q0247 Injection, sotrovimab, 500 mg 59 52 $50K
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 189 185 $50K
71046 Radiologic examination, chest; 2 views 11,671 11,491 $50K
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 659 643 $50K
76705 Ultrasound, abdominal, real time with image documentation; limited 1,966 1,936 $49K
88342 1,043 1,031 $49K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 1,784 1,758 $49K
96375 Therapeutic injection; each additional sequential IV push 12,567 10,972 $48K
76821 1,476 803 $48K
82746 4,186 4,170 $48K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 28,073 23,854 $47K
76641 1,402 1,246 $46K
84702 16,200 14,948 $46K
80050 General health panel 1,401 1,377 $44K
81025 17,433 16,736 $41K
85730 22,036 20,861 $40K
71260 Computed tomography, thorax, diagnostic; with contrast material 525 519 $40K
92592 364 269 $38K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 2,396 2,365 $37K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 852 835 $37K
44970 13 13 $37K
72125 Computed tomography, cervical spine; without contrast material 2,334 2,229 $37K
88304 1,842 1,833 $36K
77336 95 39 $35K
70498 343 341 $34K
36223 25 25 $33K
75574 193 192 $32K
M0245 Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring 122 104 $32K
86769 837 834 $30K
12002 78 78 $29K
99460 265 265 $29K
90715 1,322 1,316 $29K
97161 293 290 $28K
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 1,384 1,244 $28K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 12,943 10,382 $28K
M0222 Intravenous injection, bebtelovimab, includes injection and post administration monitoring 129 112 $28K
C1769 Guide wire 1,053 1,031 $28K
70486 957 943 $27K
87088 24,383 23,220 $27K
99238 Hospital discharge day management, 30 minutes or less 298 298 $26K
A9585 Injection, gadobutrol, 0.1 ml 1,480 869 $26K
71250 290 289 $25K
86480 495 494 $25K
87486 1,786 1,767 $24K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 37 36 $23K
88307 344 343 $23K
87581 1,786 1,767 $23K
84153 1,298 1,294 $22K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 185 184 $21K
83540 4,772 4,722 $21K
77063 Screening digital breast tomosynthesis, bilateral 1,463 1,463 $20K
84403 786 784 $19K
58662 12 12 $19K
Q0222 Injection, bebtelovimab, 175 mg 37 37 $19K
M0247 Intravenous infusion, sotrovimab, includes infusion and post administration monitoring 66 59 $19K
92593 258 251 $18K
95819 132 131 $18K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 4,450 3,659 $18K
82784 1,509 1,156 $18K
84481 1,937 1,934 $17K
81003 34,533 32,760 $17K
83655 1,323 1,320 $17K
93971 307 305 $17K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 1,820 1,812 $16K
83550 3,730 3,691 $16K
C1889 Implantable/insertable device, not otherwise classified 571 562 $16K
83921 736 735 $15K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 94 92 $15K
76813 325 325 $13K
87428 1,126 1,110 $13K
70491 65 64 $13K
29125 80 76 $13K
86376 983 976 $13K
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 97 97 $13K
76870 262 255 $13K
85027 8,505 7,636 $12K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 435 435 $11K
82947 14,154 10,794 $11K
83735 17,893 16,117 $11K
83525 1,020 1,019 $11K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 149 149 $11K
86803 1,418 1,409 $11K
92570 203 203 $10K
92526 76 27 $10K
71045 Radiologic examination, chest; single view 13,391 12,534 $10K
86870 300 266 $10K
82803 807 756 $10K
C1887 Catheter, guiding (may include infusion/perfusion capability) 495 488 $10K
84436 3,286 3,247 $10K
C1874 Stent, coated/covered, with delivery system 14 14 $10K
87040 6,218 4,705 $9K
86665 872 434 $8K
88142 431 431 $8K
86780 2,675 2,480 $8K
84550 3,000 2,777 $8K
84480 1,518 1,499 $8K
C1760 Closure device, vascular (implantable/insertable) 186 185 $8K
P9016 Red blood cells, leukocytes reduced, each unit 17 14 $8K
84146 440 435 $8K
77065 Tomosynthesis, mammo 119 103 $8K
C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser 446 438 $8K
83001 460 452 $8K
77066 Tomosynthesis, mammo 89 87 $8K
99001 214 214 $7K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 8,299 6,817 $7K
36430 17 14 $7K
87077 3,494 3,400 $7K
82550 4,450 4,184 $7K
83090 392 391 $7K
86800 550 545 $7K
86318 1,659 996 $6K
87070 5,172 5,023 $6K
70547 27 27 $6K
95004 Percutaneous tests with allergenic extracts, immediate type reaction 28 28 $6K
J7030 Infusion, normal saline solution , 1000 cc 21,752 19,709 $6K
86141 2,488 2,417 $6K
96376 2,472 1,907 $5K
84425 351 351 $5K
87340 987 980 $5K
83002 329 327 $5K
86618 346 345 $5K
M0239 Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring 19 18 $5K
86038 961 955 $5K
97162 36 36 $5K
87186 3,388 3,296 $5K
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 163 162 $5K
82670 199 183 $5K
94726 197 196 $5K
99222 Initial hospital care, per day, moderate complexity 29 29 $4K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 272 265 $4K
J0131 Injection, acetaminophen, not otherwise specified,10 mg 3,951 3,717 $4K
86706 596 589 $4K
82248 1,216 1,049 $4K
83615 1,660 1,285 $4K
94729 198 197 $4K
86140 1,098 1,072 $4K
72128 238 236 $4K
76937 24 24 $4K
86664 437 434 $4K
85007 5,661 5,284 $4K
86762 340 339 $3K
85651 2,644 2,578 $3K
86663 438 435 $3K
84630 383 383 $3K
V5266 Battery for use in hearing device 226 224 $3K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 1,737 1,722 $3K
82565 1,042 1,027 $3K
83690 14,260 13,426 $3K
74240 40 40 $3K
74174 28 27 $2K
70549 12 12 $2K
84484 13,791 10,142 $2K
J7120 Ringers lactate infusion, up to 1000 cc 1,251 1,082 $2K
84100 5,490 5,121 $2K
86923 71 66 $2K
82043 455 454 $2K
86256 170 154 $2K
J2469 Injection, palonosetron hcl, 25 mcg 40 25 $2K
74018 1,767 1,707 $2K
82785 54 38 $2K
82570 1,169 1,019 $2K
P9612 Catheterization for collection of specimen, single patient, all places of service 61 61 $2K
73630 1,656 1,549 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 111 109 $2K
29515 12 12 $2K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 6,179 5,811 $2K
C1893 Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away 188 187 $2K
90791 Psychiatric diagnostic evaluation 12 12 $2K
82627 80 80 $2K
73610 1,479 1,413 $2K
S0028 Injection, famotidine, 20 mg 3,172 2,818 $1K
99232 Subsequent hospital care, per day, moderate complexity 16 12 $1K
87184 880 849 $1K
86255 300 223 $1K
Q9963 High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml 979 823 $1K
J2704 Injection, propofol, 10 mg 8,846 6,979 $1K
82247 318 253 $1K
99221 15 15 $1K
73130 1,512 1,434 $1K
84156 1,128 932 $1K
93325 221 124 $1K
76825 13 13 $1K
81015 1,782 1,720 $1K
J2405 Injection, ondansetron hydrochloride, per 1 mg 12,519 10,600 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 858 840 $1K
J7050 Infusion, normal saline solution, 250 cc 8,114 4,871 $1K
94728 13 12 $1K
82465 219 218 $926.42
74019 2,218 2,174 $860.21
83970 26 25 $855.28
80074 25 25 $848.32
84255 37 37 $832.70
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 21 21 $801.65
85379 2,093 2,063 $799.99
0042T 13 13 $792.04
82977 168 155 $756.96
85046 793 734 $732.07
92557 12 12 $724.55
73564 1,006 977 $721.84
86787 88 88 $717.12
83605 2,312 2,019 $714.26
J2916 Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg 29 13 $694.81
94200 14 14 $690.80
J0137 Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg 1,800 1,678 $683.41
73030 1,196 1,114 $680.78
83721 183 182 $648.42
84144 31 27 $639.36
J0696 Injection, ceftriaxone sodium, per 250 mg 2,967 2,470 $627.70
83021 37 37 $609.53
84520 423 419 $598.72
85384 1,240 1,032 $591.77
88173 28 27 $577.38
84112 25 25 $576.60
73562 276 261 $565.30
Q0244 Injection, casirivimab and imdevimab, 1200 mg 28 28 $557.99
82272 410 398 $549.44
87205 561 507 $516.81
76827 13 13 $507.15
H0049 Alcohol and/or drug screening 12 12 $480.25
86431 87 87 $421.28
J8540 Dexamethasone, oral, 0.25 mg 2,136 1,723 $408.89
J0690 Injection, cefazolin sodium, 500 mg 2,561 2,369 $405.71
82077 3,511 3,127 $393.47
81001 243 226 $355.90
J1170 Injection, hydromorphone, up to 4 mg 1,564 1,410 $348.44
J1741 Injection, ibuprofen, 100 mg 65 55 $342.76
96417 18 12 $338.85
J3010 Injection, fentanyl citrate, 0.1 mg 6,817 6,320 $338.01
S0020 Injection, bupivicaine hydrochloride, 30 ml 922 902 $323.42
73070 506 442 $316.56
V5014 Repair/modification of a hearing aid 15 15 $300.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 2,708 2,426 $286.82
80143 2,420 2,291 $278.84
76642 13 13 $271.20
J0136 Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg 1,706 1,581 $268.58
73090 612 551 $249.95
80179 2,362 2,241 $242.52
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 79 51 $242.00
73110 735 693 $240.37
74178 12 12 $240.02
J2270 Injection, morphine sulfate, up to 10 mg 3,148 2,645 $239.43
84145 921 891 $236.25
87427 28 14 $210.84
85014 292 279 $209.27
86765 16 16 $206.08
86696 12 12 $179.93
94618 13 13 $165.49
Q0243 Injection, casirivimab and imdevimab, 2400 mg 39 36 $162.99
Q0239 Injection, bamlanivimab-xxxx, 700 mg 15 15 $161.97
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 388 236 $160.21
S0119 Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) 2,507 2,444 $159.00
82340 32 29 $153.13
C1729 Catheter, drainage 98 95 $141.64
J0134 Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg 521 489 $134.88
87046 28 14 $131.05
84479 149 146 $130.26
86735 16 16 $129.04
73590 539 512 $125.33
80177 29 29 $115.82
84132 376 366 $109.13
J1885 Injection, ketorolac tromethamine, per 15 mg 9,133 7,817 $105.74
87075 52 52 $92.05
87045 14 14 $89.53
J2250 Injection, midazolam hydrochloride, per 1 mg 5,219 4,937 $88.75
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 214 175 $81.26
J3475 Injection, magnesium sulfate, per 500 mg 808 703 $78.44
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 1,356 756 $77.76
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 100 94 $74.09
86592 146 130 $70.21
87275 335 329 $63.79
85008 201 179 $60.82
C1714 Catheter, transluminal atherectomy, directional 13 13 $58.80
84295 524 511 $54.98
87276 335 329 $53.33
C9113 Injection, pantoprazole sodium, per vial 131 101 $49.00
J2765 Injection, metoclopramide hcl, up to 10 mg 3,596 3,392 $47.81
82397 12 12 $44.80
J1644 Injection, heparin sodium, per 1000 units 445 400 $41.44
82150 14 13 $41.33
87807 121 119 $38.66
J1650 Injection, enoxaparin sodium, 10 mg 224 132 $34.39
80164 13 12 $31.34
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 233 176 $28.80
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 711 653 $24.34
J3480 Injection, potassium chloride, per 2 meq 459 382 $24.24
J0171 Injection, adrenalin, epinephrine, 0.1 mg 163 126 $22.50
J2060 Injection, lorazepam, 2 mg 857 706 $15.51
J0295 Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm 183 131 $14.88
J7042 5% dextrose/normal saline (500 ml = 1 unit) 60 51 $14.02
J1630 Injection, haloperidol, up to 5 mg 393 333 $13.93
S0077 Injection, clindamycin phosphate, 300 mg 12 12 $11.66
J1171 Injection, hydromorphone, 0.1 mg 49 41 $8.80
73502 54 53 $7.48
J3411 Injection, thiamine hcl, 100 mg 121 93 $6.89
J7510 Prednisolone oral, per 5 mg 63 59 $5.16
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg 59 39 $4.19
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 314 283 $3.61
J2003 Injection, lidocaine hydrochloride, 1 mg 89 86 $1.30
J1596 Injection, glycopyrrolate, 0.1 mg 135 107 $1.24
C9290 Injection, bupivacaine liposome, 1 mg 12 12 $0.00
82435 102 101 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 75 43 $0.00
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml 24 12 $0.00
73060 40 38 $0.00
90378 34 24 $0.00
J2370 Injection, phenylephrine hcl, up to 1 ml 14 14 $0.00
S0166 Injection, olanzapine, 2.5 mg 16 13 $0.00
J3360 Injection, diazepam, up to 5 mg 32 12 $0.00
99080 6,036 1,307 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 100 82 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 188 134 $0.00
J1953 Injection, levetiracetam, 10 mg 15 13 $0.00
85347 14 14 $0.00