| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,403 |
1,780 |
$647K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,089 |
1,268 |
$625K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,767 |
1,809 |
$601K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
291 |
209 |
$149K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
613 |
483 |
$107K |
| 70450 |
Computed tomography, head or brain; without contrast material |
329 |
239 |
$75K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,706 |
1,291 |
$49K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
489 |
380 |
$44K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
966 |
698 |
$41K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
771 |
576 |
$38K |
| 71045 |
Radiologic examination, chest; single view |
1,157 |
904 |
$32K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
919 |
699 |
$30K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
500 |
154 |
$27K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
788 |
611 |
$23K |
| 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 |
292 |
252 |
$18K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
20 |
14 |
$18K |
| J3490 |
Unclassified drugs |
2,419 |
958 |
$16K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
754 |
652 |
$14K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
102 |
81 |
$14K |
| 80050 |
General health panel |
1,693 |
1,328 |
$12K |
| 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 |
330 |
261 |
$12K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
736 |
565 |
$11K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
291 |
226 |
$11K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
516 |
337 |
$10K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
101 |
54 |
$8K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
504 |
416 |
$8K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
105 |
87 |
$8K |
| 96376 |
|
133 |
94 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
173 |
132 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
253 |
168 |
$6K |
| 84484 |
|
1,253 |
825 |
$5K |
| 80061 |
Lipid panel |
289 |
258 |
$3K |
| 80053 |
Comprehensive metabolic panel |
1,924 |
1,501 |
$3K |
| 83690 |
|
604 |
425 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,003 |
1,498 |
$2K |
| 82947 |
|
323 |
127 |
$2K |
| 83880 |
|
108 |
87 |
$2K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
119 |
80 |
$2K |
| 87040 |
|
304 |
124 |
$2K |
| 97161 |
|
21 |
12 |
$2K |
| 83605 |
|
308 |
199 |
$1K |
| 83735 |
|
405 |
296 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
297 |
139 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
297 |
220 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
448 |
345 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
450 |
319 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
51 |
37 |
$1K |
| 84703 |
|
222 |
171 |
$1K |
| 81001 |
|
785 |
575 |
$1K |
| 85610 |
|
557 |
347 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
148 |
123 |
$1K |
| 81025 |
|
231 |
175 |
$1K |
| 87186 |
|
209 |
135 |
$998.71 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
271 |
211 |
$983.42 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
205 |
153 |
$945.77 |
| 85379 |
|
139 |
118 |
$939.35 |
| 87077 |
|
205 |
138 |
$936.93 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
50 |
44 |
$879.35 |
| 74018 |
|
18 |
14 |
$765.12 |
| 36415 |
Collection of venous blood by venipuncture |
2,413 |
1,860 |
$725.77 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
308 |
214 |
$708.34 |
| 73610 |
|
15 |
13 |
$600.83 |
| 73630 |
|
13 |
12 |
$585.51 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
44 |
33 |
$528.52 |
| 84443 |
Thyroid stimulating hormone (TSH) |
52 |
38 |
$410.41 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
15 |
15 |
$360.59 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
15 |
15 |
$360.59 |
| 81003 |
|
335 |
254 |
$335.46 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
39 |
30 |
$324.01 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
28 |
$288.81 |
| 87807 |
|
25 |
25 |
$267.66 |
| J2060 |
Injection, lorazepam, 2 mg |
93 |
52 |
$250.91 |
| 87088 |
|
97 |
54 |
$208.78 |
| 87081 |
|
49 |
44 |
$208.72 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
35 |
33 |
$161.41 |
| 86140 |
|
32 |
31 |
$150.34 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
32 |
27 |
$141.84 |
| 82728 |
|
13 |
12 |
$126.12 |
| 36416 |
|
42 |
27 |
$115.92 |
| 80305 |
|
109 |
92 |
$67.34 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
407 |
323 |
$64.48 |
| 85652 |
|
26 |
25 |
$55.74 |
| 85027 |
|
16 |
13 |
$5.91 |
| A9270 |
Non-covered item or service |
1,022 |
413 |
$0.00 |