| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,579 |
1,350 |
$137K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
486 |
486 |
$68K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
179 |
176 |
$61K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
505 |
425 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
410 |
407 |
$42K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
976 |
831 |
$33K |
| 99215 |
Prolong outpt/office vis |
166 |
163 |
$24K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
130 |
130 |
$22K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
159 |
151 |
$16K |
| 80053 |
Comprehensive metabolic panel |
3,363 |
2,625 |
$9K |
| 99205 |
Prolong outpt/office vis |
37 |
37 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,859 |
2,270 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
132 |
128 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
172 |
168 |
$5K |
| 87486 |
|
157 |
154 |
$4K |
| 87581 |
|
157 |
154 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
247 |
238 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
27 |
27 |
$3K |
| 86140 |
|
2,122 |
1,773 |
$3K |
| 82805 |
|
256 |
221 |
$3K |
| 86710 |
|
94 |
90 |
$3K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
878 |
700 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
550 |
494 |
$2K |
| 81001 |
|
1,880 |
1,640 |
$2K |
| 84484 |
|
736 |
629 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
1,066 |
922 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
25 |
24 |
$2K |
| 83690 |
|
448 |
406 |
$1K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
20 |
12 |
$1K |
| 81025 |
|
198 |
190 |
$1K |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
155 |
135 |
$1K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,350 |
1,115 |
$1K |
| J3486 |
Injection, ziprasidone mesylate, 10 mg |
32 |
28 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
18 |
18 |
$1K |
| 85027 |
|
389 |
333 |
$1K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
176 |
173 |
$1K |
| 93000 |
|
99 |
96 |
$1K |
| 87430 |
|
61 |
60 |
$812.61 |
| 80305 |
|
78 |
70 |
$752.30 |
| 85378 |
|
113 |
110 |
$602.42 |
| 85007 |
|
344 |
307 |
$598.24 |
| 87040 |
|
27 |
27 |
$421.22 |
| 83735 |
|
260 |
228 |
$416.33 |
| 83880 |
|
13 |
13 |
$377.10 |
| 82948 |
|
65 |
41 |
$370.72 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
610 |
507 |
$370.12 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
80 |
79 |
$367.35 |
| 87081 |
|
55 |
54 |
$358.48 |
| 72100 |
|
25 |
25 |
$343.70 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
962 |
776 |
$300.68 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
169 |
136 |
$272.65 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
943 |
776 |
$247.59 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,531 |
1,232 |
$237.65 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
33 |
32 |
$235.07 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
116 |
108 |
$205.98 |
| 84443 |
Thyroid stimulating hormone (TSH) |
14 |
14 |
$205.48 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,067 |
885 |
$197.07 |
| 73030 |
|
13 |
13 |
$146.16 |
| 36415 |
Collection of venous blood by venipuncture |
84 |
70 |
$139.87 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
16 |
15 |
$107.80 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
255 |
200 |
$102.07 |
| 84439 |
|
12 |
12 |
$90.18 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
62 |
60 |
$87.34 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
129 |
116 |
$52.01 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
49 |
39 |
$35.33 |
| J2704 |
Injection, propofol, 10 mg |
13 |
12 |
$33.33 |
| 85610 |
|
15 |
12 |
$30.63 |
| J2060 |
Injection, lorazepam, 2 mg |
31 |
26 |
$16.33 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
18 |
16 |
$9.29 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
137 |
86 |
$7.06 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
51 |
46 |
$4.70 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
15 |
$0.00 |
| 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 |
21 |
21 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17 |
14 |
$0.00 |
| 80320 |
|
14 |
14 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
166 |
159 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
56 |
53 |
$0.00 |
| A9270 |
Non-covered item or service |
89 |
25 |
$-79.89 |