| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,435 |
4,638 |
$594K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,500 |
3,809 |
$499K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,175 |
1,000 |
$427K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,586 |
2,770 |
$376K |
| 70450 |
Computed tomography, head or brain; without contrast material |
831 |
669 |
$209K |
| G0378 |
Hospital observation service, per hour |
1,694 |
742 |
$71K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,273 |
1,785 |
$66K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
537 |
420 |
$45K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
995 |
900 |
$24K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
52 |
41 |
$17K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
3,709 |
3,083 |
$9K |
| 80053 |
Comprehensive metabolic panel |
6,254 |
4,583 |
$7K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,099 |
2,458 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,083 |
1,628 |
$6K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
474 |
422 |
$5K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
69 |
55 |
$4K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
51 |
45 |
$4K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
464 |
387 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
2,957 |
2,294 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,426 |
1,119 |
$2K |
| 72131 |
|
39 |
28 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,708 |
2,740 |
$2K |
| 81025 |
|
1,237 |
1,123 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,353 |
2,294 |
$1K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
321 |
271 |
$1K |
| 84703 |
|
105 |
96 |
$1K |
| 81001 |
|
1,746 |
1,387 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
17 |
16 |
$981.22 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
234 |
193 |
$854.66 |
| 84702 |
|
103 |
96 |
$702.96 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,468 |
1,637 |
$609.77 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,716 |
4,818 |
$566.48 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
30 |
26 |
$477.33 |
| 73562 |
|
17 |
14 |
$435.01 |
| 81003 |
|
1,254 |
1,088 |
$320.28 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,150 |
1,786 |
$263.99 |
| 83690 |
|
1,071 |
890 |
$213.65 |
| 71046 |
Radiologic examination, chest; 2 views |
157 |
130 |
$168.29 |
| 87070 |
|
456 |
408 |
$160.55 |
| 85610 |
|
1,440 |
1,071 |
$148.66 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
131 |
115 |
$141.32 |
| 84484 |
|
2,123 |
1,497 |
$138.64 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
653 |
522 |
$135.82 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
67 |
62 |
$107.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
12 |
$103.52 |
| 82550 |
|
239 |
173 |
$91.58 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,497 |
1,198 |
$78.19 |
| 73030 |
|
15 |
12 |
$77.96 |
| 94664 |
|
121 |
102 |
$66.86 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
536 |
425 |
$63.51 |
| 83880 |
|
435 |
349 |
$63.30 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
126 |
101 |
$55.77 |
| 86850 |
|
449 |
377 |
$44.57 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
375 |
321 |
$33.50 |
| 36415 |
Collection of venous blood by venipuncture |
3,475 |
2,362 |
$30.95 |
| 96376 |
|
247 |
129 |
$28.37 |
| 85730 |
|
1,289 |
945 |
$24.60 |
| S0028 |
Injection, famotidine, 20 mg |
444 |
368 |
$16.62 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
311 |
275 |
$15.92 |
| 87040 |
|
901 |
420 |
$14.10 |
| 85379 |
|
252 |
211 |
$9.27 |
| 83605 |
|
801 |
627 |
$7.29 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
872 |
593 |
$5.36 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
504 |
344 |
$3.39 |
| J2060 |
Injection, lorazepam, 2 mg |
181 |
122 |
$1.56 |
| 86900 |
|
450 |
378 |
$1.27 |
| 86901 |
|
450 |
378 |
$1.27 |
| C9113 |
Injection, pantoprazole sodium, per vial |
59 |
41 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
66 |
55 |
$0.00 |
| 87186 |
|
187 |
155 |
$0.00 |
| 82805 |
|
14 |
13 |
$0.00 |
| 73630 |
|
18 |
17 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
161 |
155 |
$0.00 |
| 90715 |
|
36 |
26 |
$0.00 |
| 99001 |
|
14 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
101 |
86 |
$0.00 |
| 87430 |
|
284 |
253 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
515 |
438 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
249 |
165 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
420 |
328 |
$0.00 |
| A9270 |
Non-covered item or service |
766 |
399 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
331 |
273 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
308 |
252 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
279 |
238 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
304 |
211 |
$0.00 |
| 87205 |
|
14 |
12 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
46 |
39 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
473 |
379 |
$0.00 |
| 76801 |
|
13 |
12 |
$0.00 |
| 87081 |
|
29 |
28 |
$0.00 |
| 85027 |
|
15 |
14 |
$0.00 |
| 87077 |
|
133 |
112 |
$0.00 |
| 82962 |
|
883 |
376 |
$0.00 |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
19 |
15 |
$0.00 |
| 86140 |
|
14 |
12 |
$0.00 |