| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,215 |
7,467 |
$3.76M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
10,741 |
10,093 |
$2.46M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,529 |
2,319 |
$1.01M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,965 |
1,599 |
$291K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,758 |
1,472 |
$290K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
6,245 |
6,121 |
$266K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,813 |
3,549 |
$235K |
| A0425 |
Ground mileage, per statute mile |
4,526 |
3,214 |
$213K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
166 |
131 |
$202K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,912 |
6,597 |
$170K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,594 |
6,304 |
$158K |
| 71045 |
Radiologic examination, chest; single view |
2,659 |
2,422 |
$153K |
| 80053 |
Comprehensive metabolic panel |
8,813 |
7,944 |
$75K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
413 |
377 |
$67K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
9,218 |
8,315 |
$60K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,222 |
2,032 |
$47K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
523 |
520 |
$47K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
255 |
239 |
$36K |
| 70450 |
Computed tomography, head or brain; without contrast material |
566 |
539 |
$33K |
| 59025 |
Fetal non-stress test |
183 |
149 |
$32K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,159 |
1,012 |
$26K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,051 |
915 |
$21K |
| 74018 |
|
182 |
176 |
$21K |
| 36415 |
Collection of venous blood by venipuncture |
15,478 |
13,625 |
$21K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
129 |
119 |
$20K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,143 |
1,847 |
$17K |
| 81001 |
|
6,596 |
6,051 |
$16K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,384 |
1,236 |
$15K |
| 71046 |
Radiologic examination, chest; 2 views |
166 |
164 |
$13K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,079 |
971 |
$13K |
| 87280 |
|
604 |
592 |
$13K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,241 |
1,226 |
$11K |
| G0383 |
Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
81 |
80 |
$8K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,492 |
1,198 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,168 |
1,160 |
$5K |
| 80061 |
Lipid panel |
1,209 |
1,202 |
$5K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
37 |
37 |
$4K |
| 83690 |
|
881 |
828 |
$4K |
| 84030 |
|
395 |
388 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
37 |
37 |
$3K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
79 |
72 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
28 |
28 |
$3K |
| 87088 |
|
1,546 |
1,452 |
$3K |
| 84703 |
|
221 |
208 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$2K |
| 99001 |
|
278 |
257 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,556 |
931 |
$2K |
| 87071 |
|
109 |
108 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
350 |
345 |
$1K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
29 |
28 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
127 |
118 |
$1K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
64 |
13 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
180 |
180 |
$994.49 |
| 85018 |
|
213 |
213 |
$820.74 |
| 85014 |
|
198 |
198 |
$756.12 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
30 |
26 |
$755.47 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
644 |
571 |
$634.27 |
| 84484 |
|
617 |
519 |
$547.60 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
314 |
297 |
$542.07 |
| 83520 |
|
892 |
765 |
$539.08 |
| 83880 |
|
1,053 |
975 |
$530.32 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
539 |
458 |
$516.85 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
180 |
180 |
$363.53 |
| 87186 |
|
786 |
743 |
$277.02 |
| 85730 |
|
979 |
919 |
$219.64 |
| 87040 |
|
44 |
40 |
$206.17 |
| 85610 |
|
1,091 |
1,022 |
$195.13 |
| 84439 |
|
12 |
12 |
$170.02 |
| J7638 |
Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
36 |
29 |
$117.76 |
| 83735 |
|
455 |
408 |
$69.89 |
| S0028 |
Injection, famotidine, 20 mg |
12 |
12 |
$66.50 |
| 83605 |
|
96 |
92 |
$42.94 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14 |
14 |
$42.81 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
17 |
17 |
$41.19 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
61 |
51 |
$35.59 |
| 85660 |
|
59 |
56 |
$35.33 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
59 |
54 |
$32.15 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
32 |
26 |
$24.44 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
180 |
144 |
$16.40 |
| 82962 |
|
447 |
360 |
$13.60 |
| 82607 |
|
24 |
24 |
$12.67 |
| 82550 |
|
96 |
92 |
$7.66 |
| 86900 |
|
15 |
12 |
$3.52 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
16 |
14 |
$2.16 |
| 82570 |
|
27 |
25 |
$0.00 |
| A0998 |
Ambulance response and treatment, no transport |
33 |
29 |
$0.00 |
| 82553 |
|
84 |
80 |
$0.00 |
| J3490 |
Unclassified drugs |
16 |
13 |
$0.00 |