| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,257 |
28,540 |
$1.79M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
10,210 |
7,711 |
$1.09M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
13,788 |
11,569 |
$635K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,032 |
8,029 |
$492K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,677 |
6,659 |
$450K |
| 80053 |
Comprehensive metabolic panel |
20,252 |
16,261 |
$416K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,223 |
6,280 |
$386K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,352 |
4,652 |
$330K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,319 |
5,404 |
$267K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,503 |
2,237 |
$256K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,909 |
2,563 |
$201K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,284 |
3,888 |
$195K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,127 |
2,747 |
$191K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,173 |
2,807 |
$181K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
2,940 |
2,489 |
$180K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
3,964 |
2,645 |
$171K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
23,656 |
17,995 |
$159K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
4,331 |
3,832 |
$157K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,934 |
2,304 |
$141K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,896 |
1,608 |
$131K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,424 |
2,164 |
$123K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,757 |
2,417 |
$121K |
| 80305 |
|
7,142 |
5,257 |
$111K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,474 |
1,854 |
$94K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
5,087 |
1,824 |
$93K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,738 |
2,401 |
$87K |
| 81003 |
|
2,104 |
1,475 |
$82K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,778 |
4,961 |
$72K |
| 81025 |
|
6,340 |
5,387 |
$70K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,897 |
3,429 |
$66K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,090 |
2,696 |
$58K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,405 |
3,403 |
$57K |
| 99000 |
|
2,989 |
2,597 |
$56K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
842 |
754 |
$56K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
7,364 |
5,529 |
$54K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,221 |
1,943 |
$53K |
| 81001 |
|
14,595 |
12,114 |
$51K |
| 84484 |
|
6,457 |
4,279 |
$49K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
1,415 |
1,275 |
$48K |
| 99215 |
Prolong outpt/office vis |
710 |
593 |
$47K |
| 80061 |
Lipid panel |
3,437 |
3,014 |
$45K |
| 87660 |
|
2,108 |
1,836 |
$41K |
| 87480 |
|
2,108 |
1,836 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
832 |
705 |
$37K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
580 |
319 |
$37K |
| 84702 |
|
871 |
551 |
$35K |
| 83690 |
|
5,992 |
4,925 |
$34K |
| 87510 |
|
2,108 |
1,836 |
$33K |
| 87430 |
|
695 |
661 |
$33K |
| 76830 |
Ultrasound, transvaginal |
875 |
780 |
$32K |
| 71046 |
Radiologic examination, chest; 2 views |
3,702 |
3,325 |
$31K |
| 83605 |
|
3,491 |
2,794 |
$29K |
| 82948 |
|
1,194 |
808 |
$28K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
423 |
385 |
$28K |
| 85610 |
|
3,768 |
3,039 |
$27K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
652 |
570 |
$25K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,591 |
871 |
$24K |
| 82550 |
|
3,904 |
2,747 |
$24K |
| 83880 |
|
1,205 |
1,050 |
$24K |
| 83735 |
|
5,075 |
3,877 |
$23K |
| 59050 |
|
328 |
233 |
$22K |
| 87186 |
|
2,394 |
2,004 |
$22K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
283 |
260 |
$21K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
327 |
296 |
$21K |
| 84145 |
|
1,213 |
1,051 |
$19K |
| 82950 |
|
405 |
368 |
$19K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
559 |
506 |
$19K |
| 73630 |
|
1,922 |
1,633 |
$18K |
| 82553 |
|
3,667 |
2,610 |
$18K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
960 |
431 |
$17K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
263 |
239 |
$16K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
608 |
519 |
$15K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
648 |
583 |
$15K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
484 |
396 |
$14K |
| 81513 |
|
183 |
164 |
$13K |
| 87077 |
|
1,984 |
1,654 |
$13K |
| 85379 |
|
1,736 |
1,561 |
$13K |
| 97161 |
|
422 |
375 |
$12K |
| 87634 |
|
222 |
205 |
$12K |
| 86803 |
|
725 |
627 |
$12K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
236 |
221 |
$12K |
| 87507 |
|
29 |
28 |
$11K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
136 |
127 |
$11K |
| 87040 |
|
1,587 |
793 |
$10K |
| 82565 |
|
520 |
387 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
181 |
153 |
$9K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,614 |
8,203 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,163 |
3,387 |
$8K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,064 |
259 |
$8K |
| 93976 |
|
313 |
271 |
$8K |
| 20610 |
|
150 |
121 |
$8K |
| 73610 |
|
1,377 |
1,138 |
$7K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
175 |
169 |
$7K |
| 73030 |
|
890 |
725 |
$7K |
| 73110 |
|
556 |
443 |
$7K |
| 87081 |
|
681 |
644 |
$7K |
| 85730 |
|
1,609 |
1,428 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
5,878 |
5,078 |
$7K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
243 |
216 |
$6K |
| 97162 |
|
186 |
162 |
$6K |
| 0240U |
|
209 |
187 |
$6K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
196 |
175 |
$6K |
| 86140 |
|
1,187 |
980 |
$6K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
11,048 |
8,870 |
$6K |
| 84703 |
|
610 |
542 |
$5K |
| 87070 |
|
357 |
303 |
$5K |
| 87481 |
|
183 |
164 |
$5K |
| 73130 |
|
729 |
638 |
$5K |
| 84439 |
|
620 |
546 |
$5K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
41 |
32 |
$5K |
| 99205 |
Prolong outpt/office vis |
65 |
60 |
$4K |
| 86780 |
|
376 |
328 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
102 |
94 |
$4K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
85 |
38 |
$4K |
| 59025 |
Fetal non-stress test |
52 |
24 |
$4K |
| 82728 |
|
235 |
203 |
$4K |
| 80055 |
|
29 |
28 |
$4K |
| 88142 |
|
200 |
173 |
$4K |
| 82962 |
|
1,480 |
704 |
$4K |
| 80050 |
General health panel |
1,320 |
1,105 |
$3K |
| 85027 |
|
679 |
521 |
$3K |
| 90715 |
|
403 |
353 |
$3K |
| 82077 |
|
371 |
285 |
$3K |
| 94664 |
|
120 |
107 |
$3K |
| 83540 |
|
240 |
209 |
$3K |
| 97035 |
|
126 |
50 |
$3K |
| 0001A |
|
184 |
148 |
$3K |
| 85652 |
|
919 |
767 |
$3K |
| 0002A |
|
152 |
128 |
$3K |
| 93971 |
|
91 |
81 |
$3K |
| 12001 |
|
36 |
24 |
$3K |
| 87340 |
|
318 |
266 |
$3K |
| 86703 |
|
195 |
169 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,736 |
5,938 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
26 |
25 |
$2K |
| G0378 |
Hospital observation service, per hour |
515 |
402 |
$2K |
| 73562 |
|
590 |
532 |
$2K |
| 85014 |
|
366 |
311 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,306 |
1,040 |
$2K |
| 90674 |
|
217 |
177 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
22,728 |
16,180 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
54 |
46 |
$2K |
| 82570 |
|
183 |
151 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
168 |
143 |
$2K |
| 86901 |
|
644 |
507 |
$1K |
| 86900 |
|
626 |
493 |
$1K |
| 83550 |
|
206 |
179 |
$1K |
| 80329 |
|
755 |
622 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
222 |
196 |
$1K |
| 86850 |
|
359 |
275 |
$1K |
| 90686 |
|
50 |
46 |
$1K |
| 72100 |
|
322 |
287 |
$1K |
| Q9962 |
High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml |
1,321 |
1,185 |
$970.88 |
| 80143 |
|
82 |
65 |
$960.24 |
| 80179 |
|
81 |
65 |
$929.67 |
| 91322 |
|
21 |
18 |
$928.64 |
| 85018 |
|
273 |
238 |
$882.17 |
| 70486 |
|
13 |
12 |
$761.41 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
14 |
13 |
$750.66 |
| 82247 |
|
22 |
17 |
$712.32 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
21 |
$711.60 |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
14 |
12 |
$688.73 |
| 80074 |
|
15 |
15 |
$664.47 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$659.38 |
| 86762 |
|
16 |
13 |
$645.44 |
| 76642 |
|
17 |
12 |
$637.69 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,584 |
1,317 |
$629.00 |
| 87205 |
|
226 |
191 |
$617.67 |
| 86704 |
|
68 |
56 |
$604.03 |
| 86708 |
|
66 |
54 |
$582.62 |
| 86706 |
|
72 |
60 |
$571.87 |
| 90480 |
|
33 |
29 |
$533.34 |
| 73502 |
|
63 |
51 |
$511.93 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$507.32 |
| 90834 |
Psychotherapy, 45 minutes with patient |
26 |
16 |
$449.89 |
| 73560 |
|
77 |
64 |
$425.85 |
| G0008 |
Administration of influenza virus vaccine |
246 |
206 |
$405.56 |
| 36592 |
|
4,252 |
3,364 |
$402.92 |
| 96376 |
|
2,976 |
2,266 |
$383.62 |
| 87493 |
|
13 |
12 |
$354.27 |
| 93017 |
|
12 |
12 |
$337.95 |
| 0031A |
|
26 |
17 |
$337.47 |
| 0004A |
|
22 |
20 |
$293.51 |
| 84100 |
|
86 |
67 |
$276.39 |
| 82803 |
|
17 |
13 |
$273.45 |
| 74018 |
|
79 |
72 |
$202.31 |
| 82043 |
|
41 |
38 |
$193.44 |
| 90656 |
|
31 |
31 |
$191.46 |
| 82607 |
|
12 |
12 |
$189.81 |
| 97163 |
|
14 |
12 |
$189.63 |
| 99441 |
|
34 |
16 |
$188.37 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
6,657 |
5,386 |
$160.39 |
| 80320 |
|
1,340 |
1,086 |
$149.03 |
| 73140 |
|
49 |
41 |
$130.24 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
210 |
176 |
$126.00 |
| 73590 |
|
13 |
12 |
$125.82 |
| 84550 |
|
43 |
36 |
$118.39 |
| 84450 |
|
15 |
12 |
$101.11 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
5,293 |
4,352 |
$89.16 |
| J2060 |
Injection, lorazepam, 2 mg |
1,178 |
996 |
$75.41 |
| 82248 |
|
18 |
13 |
$70.50 |
| 91307 |
|
49 |
35 |
$69.76 |
| 11721 |
|
12 |
12 |
$57.63 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
2,541 |
2,209 |
$54.89 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
17 |
16 |
$51.31 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
16 |
14 |
$46.83 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,549 |
2,227 |
$40.10 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
546 |
357 |
$34.45 |
| 91300 |
|
224 |
150 |
$32.10 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,378 |
1,192 |
$30.28 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
1,235 |
1,126 |
$12.73 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
578 |
499 |
$12.73 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
277 |
239 |
$11.84 |
| 97597 |
|
21 |
12 |
$11.60 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
563 |
425 |
$9.97 |
| J2704 |
Injection, propofol, 10 mg |
955 |
799 |
$6.97 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
1,739 |
1,454 |
$2.43 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,300 |
1,661 |
$1.98 |
| J3490 |
Unclassified drugs |
1,209 |
855 |
$1.71 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
860 |
643 |
$0.91 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,397 |
1,815 |
$0.77 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,057 |
690 |
$0.17 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,367 |
1,143 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
57 |
48 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
521 |
417 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
255 |
212 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
929 |
765 |
$0.00 |
| A9270 |
Non-covered item or service |
680 |
386 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
141 |
99 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
13 |
13 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
15 |
14 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
13 |
12 |
$0.00 |
| 51798 |
|
15 |
13 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
37 |
30 |
$0.00 |
| Q9969 |
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose |
18 |
13 |
$0.00 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
15 |
14 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
136 |
112 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
44 |
37 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
20 |
14 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
20 |
12 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
26 |
24 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
43 |
24 |
$0.00 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
61 |
40 |
$0.00 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
14 |
12 |
$0.00 |