| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
146 |
145 |
$19K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
90 |
82 |
$10K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
27 |
27 |
$4K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
27 |
27 |
$4K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
86 |
86 |
$3K |
| 76642 |
|
14 |
12 |
$825.17 |
| 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 |
34 |
34 |
$483.63 |
| 71046 |
Radiologic examination, chest; 2 views |
35 |
34 |
$444.65 |
| 80053 |
Comprehensive metabolic panel |
68 |
68 |
$367.90 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
18 |
18 |
$240.97 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17 |
17 |
$174.44 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
51 |
49 |
$135.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
29 |
29 |
$130.76 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
93 |
92 |
$61.89 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
63 |
63 |
$46.42 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
18 |
18 |
$41.67 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
47 |
45 |
$40.50 |
| 84484 |
|
23 |
20 |
$32.35 |
| 83735 |
|
13 |
12 |
$20.25 |
| 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 |
32 |
32 |
$17.60 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
45 |
43 |
$14.88 |
| 81025 |
|
47 |
46 |
$12.60 |
| 83690 |
|
19 |
19 |
$11.80 |
| 81001 |
|
59 |
58 |
$11.68 |
| 87210 |
|
15 |
15 |
$7.90 |
| 81003 |
|
15 |
14 |
$5.60 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
19 |
17 |
$0.78 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
15 |
14 |
$0.00 |