| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,528 |
1,417 |
$267K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,230 |
3,834 |
$231K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
725 |
677 |
$191K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,570 |
1,491 |
$171K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,086 |
995 |
$98K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
352 |
340 |
$40K |
| 71046 |
Radiologic examination, chest; 2 views |
994 |
947 |
$28K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,069 |
312 |
$26K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
416 |
400 |
$26K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
289 |
259 |
$23K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
887 |
762 |
$19K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
584 |
490 |
$17K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
665 |
658 |
$17K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
621 |
614 |
$15K |
| 70450 |
Computed tomography, head or brain; without contrast material |
230 |
225 |
$12K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
104 |
93 |
$10K |
| 80061 |
Lipid panel |
731 |
730 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
177 |
177 |
$8K |
| 80053 |
Comprehensive metabolic panel |
2,932 |
2,632 |
$7K |
| 86900 |
|
185 |
182 |
$7K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,005 |
984 |
$7K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
55 |
54 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
4,618 |
3,932 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
422 |
163 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,650 |
2,389 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
67 |
67 |
$4K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
72 |
71 |
$4K |
| 76830 |
Ultrasound, transvaginal |
57 |
57 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
58 |
58 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
175 |
173 |
$3K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
173 |
172 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
883 |
819 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
352 |
329 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
444 |
388 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
369 |
369 |
$2K |
| 85027 |
|
801 |
758 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
703 |
625 |
$2K |
| 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 |
348 |
284 |
$1K |
| 87081 |
|
1,052 |
836 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
182 |
178 |
$1K |
| 86780 |
|
146 |
146 |
$1K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
358 |
338 |
$1K |
| 87653 |
|
53 |
53 |
$1K |
| 73630 |
|
169 |
164 |
$1K |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
113 |
113 |
$983.06 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
618 |
560 |
$913.64 |
| 87077 |
|
331 |
321 |
$694.46 |
| 84439 |
|
150 |
146 |
$669.30 |
| 72100 |
|
29 |
28 |
$643.77 |
| 82947 |
|
219 |
146 |
$615.12 |
| 73130 |
|
127 |
121 |
$578.67 |
| 81001 |
|
1,702 |
1,559 |
$561.98 |
| 87186 |
|
255 |
249 |
$560.09 |
| 73562 |
|
81 |
77 |
$558.23 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
26 |
25 |
$532.50 |
| 97162 |
|
13 |
12 |
$503.40 |
| 73610 |
|
104 |
101 |
$473.04 |
| 82728 |
|
57 |
57 |
$462.44 |
| 85610 |
|
419 |
328 |
$462.21 |
| 82607 |
|
48 |
48 |
$403.34 |
| 86140 |
|
585 |
552 |
$400.79 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
12 |
12 |
$381.23 |
| 86703 |
|
61 |
61 |
$369.79 |
| 87205 |
|
300 |
288 |
$336.61 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
26 |
25 |
$312.64 |
| 83880 |
|
74 |
68 |
$294.60 |
| 97161 |
|
15 |
14 |
$290.29 |
| 80305 |
|
142 |
136 |
$263.53 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
446 |
262 |
$252.57 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
724 |
709 |
$243.71 |
| 84702 |
|
42 |
27 |
$208.33 |
| 85007 |
|
289 |
263 |
$203.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
28 |
$201.90 |
| 87340 |
|
62 |
62 |
$185.40 |
| 83735 |
|
109 |
91 |
$178.50 |
| 86762 |
|
37 |
37 |
$163.44 |
| 82570 |
|
58 |
57 |
$158.81 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
14 |
14 |
$153.15 |
| 83690 |
|
586 |
545 |
$147.21 |
| 85652 |
|
158 |
149 |
$141.13 |
| 87070 |
|
65 |
63 |
$130.35 |
| 82950 |
|
43 |
42 |
$125.61 |
| 87147 |
|
128 |
126 |
$118.86 |
| 85730 |
|
217 |
213 |
$93.09 |
| 73564 |
|
13 |
13 |
$81.56 |
| 81025 |
|
974 |
898 |
$79.06 |
| 82043 |
|
13 |
13 |
$47.55 |
| 86850 |
|
160 |
158 |
$46.37 |
| 84484 |
|
430 |
307 |
$19.05 |
| 81003 |
|
70 |
67 |
$18.69 |
| 87807 |
|
66 |
66 |
$15.06 |
| 81002 |
|
396 |
381 |
$14.15 |
| 87040 |
|
30 |
28 |
$12.97 |
| 83605 |
|
400 |
342 |
$6.71 |
| 85379 |
|
12 |
12 |
$6.39 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
845 |
754 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
395 |
321 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
326 |
235 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
600 |
530 |
$0.00 |
| 96376 |
|
182 |
145 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
124 |
118 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
389 |
343 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
350 |
307 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
97 |
87 |
$0.00 |
| A9270 |
Non-covered item or service |
154 |
135 |
$0.00 |
| 86901 |
|
88 |
86 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
30 |
29 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
107 |
101 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
148 |
69 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
211 |
175 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
410 |
393 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
308 |
269 |
$0.00 |
| 90715 |
|
44 |
43 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
987 |
846 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
465 |
362 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,336 |
1,066 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
32 |
27 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
124 |
101 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
16 |
13 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
14 |
14 |
$0.00 |
| 87420 |
|
12 |
12 |
$0.00 |