NPI: 1932208576 · CHAPEL HILL, NC 27514 · Air Ambulance · NPI assigned 09/21/2006
Authorized official BROWN, LATONYA controls 20+ related entities in our dataset. Read more
| Authorized Official | BROWN, LATONYA (CHIEF FINANCIAL OFFICER) |
| NPI Enumeration Date | 09/21/2006 |
Other providers sharing the same authorized official: BROWN, LATONYA
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 142,302 | $5.56M |
| 2019 | 153,433 | $6.17M |
| 2020 | 89,290 | $3.57M |
| 2021 | 147,349 | $7.20M |
| 2022 | 145,769 | $8.88M |
| 2023 | 164,632 | $9.38M |
| 2024 | 157,421 | $9.85M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 239,840 | 213,795 | $11.95M |
| 99283 | Emergency department visit for the evaluation and management, moderate severity | 38,265 | 35,989 | $6.24M |
| 99284 | Emergency department visit for the evaluation and management, high severity | 22,785 | 20,927 | $6.23M |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 1,770 | 1,645 | $4.75M |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 306 | 235 | $2.06M |
| 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 | 18,311 | 16,242 | $1.40M |
| J3490 | Unclassified drugs | 143,889 | 42,063 | $1.20M |
| 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | 3,507 | 3,099 | $1.09M |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 12,392 | 10,166 | $1.04M |
| 41899 | Unlisted procedure, dentoalveolar structures | 556 | 478 | $968K |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | 264 | 252 | $761K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 94,024 | 78,276 | $717K |
| 70551 | Magnetic resonance imaging, brain; without contrast material | 814 | 773 | $697K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 3,804 | 3,608 | $670K |
| 76770 | 3,442 | 3,221 | $609K | |
| 94010 | 3,632 | 3,430 | $573K | |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 2,660 | 2,400 | $459K |
| 72082 | 2,312 | 2,213 | $421K | |
| 80053 | Comprehensive metabolic panel | 38,709 | 33,571 | $418K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 9,755 | 8,317 | $387K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | 3,155 | 1,748 | $382K |
| 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 | 13,995 | 12,389 | $326K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 4,543 | 3,259 | $282K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 3,648 | 3,257 | $256K |
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) | 448 | 291 | $247K |
| 92567 | 10,206 | 9,507 | $234K | |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | 318 | 294 | $214K |
| 97803 | 5,188 | 4,957 | $210K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 4,227 | 4,113 | $206K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 2,821 | 2,222 | $204K |
| 96375 | Therapeutic injection; each additional sequential IV push | 3,838 | 3,265 | $168K |
| J7120 | Ringers lactate infusion, up to 1000 cc | 8,345 | 7,562 | $160K |
| 93296 | 5,941 | 5,713 | $156K | |
| J7050 | Infusion, normal saline solution, 250 cc | 17,807 | 9,869 | $155K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1,773 | 1,716 | $153K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 265 | 257 | $130K |
| P9016 | Red blood cells, leukocytes reduced, each unit | 318 | 297 | $122K |
| Q3014 | Telehealth originating site facility fee | 2,818 | 2,418 | $120K |
| 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 | 2,039 | 1,388 | $118K |
| 36512 | 270 | 251 | $116K | |
| 36415 | Collection of venous blood by venipuncture | 41,292 | 36,300 | $115K |
| 84443 | Thyroid stimulating hormone (TSH) | 4,909 | 4,503 | $110K |
| J2704 | Injection, propofol, 10 mg | 9,937 | 7,517 | $105K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 2,660 | 2,495 | $104K |
| 96361 | Intravenous infusion, hydration; each additional hour | 1,859 | 1,218 | $98K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 1,743 | 1,282 | $97K |
| 77386 | 124 | 12 | $93K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 399 | 380 | $91K |
| 72170 | 1,104 | 1,060 | $85K | |
| 83036 | Hemoglobin; glycosylated (A1C) | 6,122 | 5,675 | $79K |
| 82677 | 3,140 | 2,520 | $77K | |
| 83021 | 2,781 | 2,446 | $76K | |
| 70260 | 366 | 347 | $65K | |
| 86003 | 476 | 416 | $63K | |
| 71046 | Radiologic examination, chest; 2 views | 1,009 | 938 | $63K |
| 82105 | 3,857 | 3,104 | $61K | |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | 107 | 96 | $61K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 173 | 167 | $61K |
| 86140 | 9,366 | 8,551 | $59K | |
| 77073 | 395 | 378 | $59K | |
| 82728 | 2,919 | 2,666 | $55K | |
| 97163 | 483 | 461 | $55K | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 521 | 406 | $54K |
| 86336 | 3,140 | 2,520 | $53K | |
| A0436 | Rotary wing air mileage, per statute mile | 306 | 235 | $51K |
| 81001 | 14,463 | 12,877 | $50K | |
| 92526 | 554 | 522 | $48K | |
| 92579 | 585 | 526 | $46K | |
| 43762 | 154 | 148 | $44K | |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | 13 | 12 | $43K |
| 92582 | 519 | 447 | $42K | |
| 84439 | 3,153 | 2,965 | $40K | |
| G0378 | Hospital observation service, per hour | 471 | 231 | $40K |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | 544 | 389 | $40K |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 5,772 | 4,498 | $40K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 502 | 383 | $39K |
| 54161 | 39 | 38 | $38K | |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 38 | 36 | $32K |
| 94375 | 545 | 483 | $32K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 933 | 733 | $32K |
| 80047 | 5,947 | 4,469 | $31K | |
| 84702 | 3,302 | 2,671 | $30K | |
| 59025 | Fetal non-stress test | 356 | 309 | $28K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 373 | 249 | $26K |
| 85027 | 3,017 | 2,677 | $26K | |
| 83880 | 883 | 692 | $25K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 3,384 | 2,918 | $25K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 392 | 384 | $24K |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | 470 | 445 | $23K |
| A4217 | Sterile water/saline, 500 ml | 1,461 | 1,090 | $23K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | 77 | 62 | $22K |
| J0490 | Injection, belimumab, 10 mg | 29 | 25 | $21K |
| 92557 | 277 | 270 | $21K | |
| 84450 | 4,884 | 4,460 | $20K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 237 | 180 | $20K |
| 85046 | 2,446 | 2,197 | $20K | |
| 85652 | 5,156 | 4,657 | $20K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 614 | 492 | $19K |
| 51600 | 108 | 105 | $19K | |
| 31526 | 51 | 49 | $19K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 3,358 | 2,979 | $19K |
| 72081 | 156 | 154 | $19K | |
| J0690 | Injection, cefazolin sodium, 500 mg | 1,094 | 875 | $18K |
| 82977 | 1,990 | 1,762 | $18K | |
| 83540 | 2,074 | 1,958 | $18K | |
| 87522 | Neg quan hep c or qual rna | 739 | 623 | $18K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 3,505 | 3,098 | $17K |
| 97535 | Self-care/home management training, each 15 minutes | 768 | 680 | $17K |
| 76801 | 225 | 177 | $16K | |
| 73521 | 94 | 88 | $16K | |
| 83735 | 3,631 | 2,697 | $16K | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 1,814 | 1,508 | $16K |
| 84460 | 5,643 | 5,130 | $16K | |
| 93926 | 177 | 166 | $15K | |
| 82607 | 756 | 718 | $15K | |
| 82962 | 5,403 | 4,784 | $15K | |
| 87081 | 942 | 895 | $15K | |
| 81003 | 5,808 | 4,955 | $15K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 817 | 751 | $15K |
| 87536 | 226 | 209 | $14K | |
| 74174 | 14 | 12 | $14K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 19 | 13 | $14K |
| 82565 | 4,151 | 3,749 | $14K | |
| 93297 | 2,273 | 2,185 | $14K | |
| 80048 | Basic metabolic panel (calcium, ionized) | 2,204 | 1,819 | $13K |
| 74455 | 65 | 65 | $13K | |
| 30930 | 41 | 40 | $13K | |
| 93922 | 255 | 238 | $13K | |
| 80061 | Lipid panel | 619 | 582 | $13K |
| 83550 | 946 | 882 | $12K | |
| 84466 | 814 | 783 | $12K | |
| 31575 | 74 | 70 | $12K | |
| 84484 | 1,213 | 959 | $12K | |
| 86902 | 306 | 281 | $12K | |
| 80069 | 1,041 | 821 | $12K | |
| 83690 | 1,537 | 1,407 | $11K | |
| 87631 | 146 | 107 | $11K | |
| 87070 | 926 | 875 | $11K | |
| 36416 | 3,691 | 3,441 | $11K | |
| 73630 | 156 | 133 | $11K | |
| 73110 | 149 | 126 | $11K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 101 | 88 | $11K |
| 31622 | 29 | 28 | $11K | |
| J2997 | Injection, alteplase recombinant, 1 mg | 91 | 76 | $10K |
| 77066 | Tomosynthesis, mammo | 231 | 205 | $9K |
| 99199 | Unlisted special service, procedure or report | 1,525 | 1,075 | $9K |
| 80076 | 1,504 | 1,297 | $9K | |
| 94618 | 102 | 94 | $9K | |
| 86160 | 287 | 246 | $9K | |
| 76642 | 179 | 147 | $8K | |
| 96415 | 47 | 41 | $8K | |
| 82784 | 716 | 646 | $8K | |
| 92587 | 68 | 58 | $8K | |
| 77072 | 94 | 93 | $8K | |
| 76819 | Fetal biophysical profile; without non-stress testing | 147 | 108 | $8K |
| 84425 | 263 | 245 | $8K | |
| 81025 | 931 | 853 | $8K | |
| 77065 | Tomosynthesis, mammo | 240 | 212 | $7K |
| 80197 | 1,191 | 806 | $7K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 231 | 212 | $7K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 1,242 | 1,131 | $7K |
| 85044 | 1,387 | 1,228 | $7K | |
| 73140 | 103 | 93 | $7K | |
| 97166 | 62 | 60 | $7K | |
| 82040 | 1,062 | 945 | $7K | |
| 86833 | 110 | 97 | $6K | |
| J8540 | Dexamethasone, oral, 0.25 mg | 2,326 | 1,279 | $6K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 171 | 161 | $6K |
| 86300 | 314 | 266 | $6K | |
| 73564 | 129 | 126 | $6K | |
| 84075 | 910 | 812 | $6K | |
| 82570 | 1,967 | 1,473 | $6K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 171 | 161 | $6K |
| 36591 | 198 | 155 | $5K | |
| 74183 | 18 | 13 | $5K | |
| 70450 | Computed tomography, head or brain; without contrast material | 12 | 12 | $5K |
| 84520 | 1,976 | 1,819 | $5K | |
| 86832 | 99 | 86 | $5K | |
| 85610 | 1,517 | 1,293 | $5K | |
| 87497 | 476 | 360 | $5K | |
| 83516 | 340 | 333 | $5K | |
| 82610 | 206 | 201 | $5K | |
| 95886 | 62 | 62 | $4K | |
| 87799 | 92 | 76 | $4K | |
| 95885 | 43 | 43 | $4K | |
| 71045 | Radiologic examination, chest; single view | 96 | 90 | $4K |
| 82746 | 209 | 198 | $4K | |
| 92610 | 40 | 40 | $4K | |
| 97802 | 89 | 82 | $4K | |
| 73503 | 40 | 40 | $4K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 246 | 209 | $4K |
| 85651 | 1,420 | 1,357 | $4K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 74 | 73 | $4K |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 1,292 | 1,166 | $4K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 37 | 37 | $4K |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 479 | 364 | $4K |
| 93303 | Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study | 24 | 24 | $3K |
| 90686 | 600 | 558 | $3K | |
| 84156 | 1,711 | 1,299 | $3K | |
| 72100 | 26 | 25 | $3K | |
| 86225 | 172 | 140 | $3K | |
| 0071A | 65 | 44 | $3K | |
| 73502 | 39 | 36 | $3K | |
| 96367 | 58 | 39 | $3K | |
| 83615 | 582 | 501 | $3K | |
| 90870 | 50 | 37 | $3K | |
| 71250 | 12 | 12 | $3K | |
| 94729 | 30 | 28 | $3K | |
| 92555 | 110 | 89 | $2K | |
| 84100 | 1,029 | 805 | $2K | |
| 90656 | 147 | 147 | $2K | |
| 73562 | 69 | 66 | $2K | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 1,068 | 868 | $2K |
| 85660 | 372 | 266 | $2K | |
| 93325 | 24 | 24 | $2K | |
| 93320 | 24 | 24 | $2K | |
| 97597 | 57 | 52 | $2K | |
| 80143 | 733 | 203 | $2K | |
| 86592 | 343 | 317 | $2K | |
| 86850 | 147 | 140 | $2K | |
| 73090 | 16 | 13 | $2K | |
| 72110 | 12 | 12 | $2K | |
| 83655 | 88 | 74 | $2K | |
| 86480 | 25 | 24 | $2K | |
| 73030 | 29 | 28 | $2K | |
| 86360 | 25 | 24 | $1K | |
| 97167 | 14 | 14 | $1K | |
| 86364 | 104 | 102 | $1K | |
| 97804 | 13 | 12 | $1K | |
| 76000 | 12 | 12 | $1K | |
| 86677 | 84 | 80 | $1K | |
| J8597 | Antiemetic drug, oral, not otherwise specified | 199 | 190 | $1K |
| 97760 | 31 | 30 | $1K | |
| C1769 | Guide wire | 29 | 25 | $1K |
| 84305 | 55 | 53 | $1K | |
| 86334 | 66 | 55 | $1K | |
| 73552 | 14 | 12 | $1K | |
| 11721 | 75 | 66 | $1K | |
| 82248 | 254 | 222 | $1K | |
| 84436 | 137 | 135 | $1K | |
| 86359 | 25 | 24 | $1K | |
| 95816 | 13 | 13 | $1K | |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 199 | 188 | $1K |
| 96409 | 14 | 13 | $1K | |
| J9370 | Vincristine sulfate, 1 mg | 19 | 16 | $1K |
| 51798 | 59 | 53 | $1K | |
| 87077 | 73 | 71 | $1K | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 106 | 93 | $1K |
| 85240 | 39 | 36 | $1K | |
| 80179 | 723 | 201 | $984.06 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 56 | 53 | $963.74 |
| 86900 | 341 | 298 | $893.20 | |
| 86901 | 341 | 298 | $885.77 | |
| C1889 | Implantable/insertable device, not otherwise classified | 36 | 36 | $842.37 |
| 96417 | 20 | 12 | $820.62 | |
| 86923 | 26 | 25 | $811.20 | |
| 83521 | 50 | 40 | $779.11 | |
| 91200 | 12 | 12 | $757.46 | |
| 83970 | 13 | 12 | $741.96 | |
| 84590 | 53 | 52 | $731.72 | |
| 72040 | 16 | 12 | $728.84 | |
| 43760 | 13 | 13 | $723.25 | |
| 91307 | 105 | 67 | $634.59 | |
| 92556 | 16 | 13 | $633.46 | |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 112 | 103 | $596.19 |
| 84165 | 66 | 55 | $579.25 | |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 40 | 37 | $531.06 |
| 84403 | 13 | 13 | $529.84 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 146 | 129 | $527.62 |
| 88112 | 189 | 124 | $527.61 | |
| 17111 | 14 | 14 | $500.57 | |
| 84402 | 12 | 12 | $476.79 | |
| 87340 | 39 | 36 | $474.28 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 46 | 46 | $444.17 |
| 82948 | 70 | 68 | $361.66 | |
| 82465 | 38 | 37 | $341.90 | |
| 93299 | 78 | 75 | $338.92 | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | 13 | 13 | $335.60 |
| 86787 | 15 | 15 | $330.03 | |
| 36592 | 13 | 12 | $303.46 | |
| 84446 | 12 | 12 | $302.37 | |
| 87205 | 54 | 51 | $292.37 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 70 | 66 | $273.64 |
| 86705 | 12 | 12 | $257.52 | |
| C1887 | Catheter, guiding (may include infusion/perfusion capability) | 15 | 13 | $256.88 |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | 14 | 13 | $256.64 |
| C1894 | Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser | 15 | 13 | $255.10 |
| 86704 | 12 | 12 | $254.76 | |
| 87181 | 27 | 27 | $242.72 | |
| 84630 | 26 | 25 | $238.87 | |
| 86706 | 12 | 12 | $226.20 | |
| J7030 | Infusion, normal saline solution , 1000 cc | 13 | 12 | $221.13 |
| 96523 | 13 | 13 | $219.78 | |
| A9270 | Non-covered item or service | 6,310 | 2,580 | $207.87 |
| 85007 | 41 | 31 | $193.31 | |
| 99152 | 14 | 12 | $190.08 | |
| 82247 | 27 | 26 | $184.27 | |
| 82950 | 27 | 25 | $178.54 | |
| J0295 | Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm | 22 | 12 | $177.48 |
| J1644 | Injection, heparin sodium, per 1000 units | 27 | 13 | $126.61 |
| 82310 | 12 | 12 | $112.85 | |
| 81511 | 30 | 18 | $108.62 | |
| 87184 | 12 | 12 | $94.38 | |
| J0610 | Injection, calcium gluconate (fresenius kabi), per 10 ml | 14 | 12 | $74.83 |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | 13 | 13 | $73.30 |
| J3260 | Injection, tobramycin sulfate, up to 80 mg | 14 | 13 | $62.77 |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 37 | 25 | $61.80 |
| 82043 | 17 | 12 | $57.68 | |
| 82550 | 12 | 12 | $47.48 | |
| 84153 | 12 | 12 | $22.92 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 13 | 12 | $18.45 |
| 84550 | 19 | 12 | $13.86 | |
| Q0244 | Injection, casirivimab and imdevimab, 1200 mg | 56 | 41 | $1.68 |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | 151 | 72 | $0.00 |
| 84478 | 26 | 25 | $0.00 | |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 35 | 33 | $0.00 |
| J2357 | Injection, omalizumab, 5 mg | 15 | 12 | $0.00 |
| Q9958 | High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml | 79 | 77 | $0.00 |
| 83006 | 13 | 13 | $0.00 | |
| A9577 | Injection, gadobenate dimeglumine (multihance), per ml | 18 | 13 | $0.00 |