| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,301 |
2,098 |
$590K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,398 |
1,255 |
$529K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,238 |
2,121 |
$413K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
310 |
296 |
$128K |
| 87631 |
|
992 |
943 |
$116K |
| 70450 |
Computed tomography, head or brain; without contrast material |
431 |
402 |
$109K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,313 |
1,147 |
$102K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,273 |
1,095 |
$99K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
317 |
294 |
$88K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
684 |
627 |
$78K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
657 |
627 |
$76K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
557 |
464 |
$66K |
| 71045 |
Radiologic examination, chest; single view |
1,016 |
911 |
$61K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,517 |
1,298 |
$56K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
259 |
195 |
$34K |
| 80053 |
Comprehensive metabolic panel |
2,652 |
2,282 |
$33K |
| 71250 |
|
136 |
133 |
$29K |
| 71046 |
Radiologic examination, chest; 2 views |
386 |
370 |
$28K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
546 |
493 |
$28K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
885 |
813 |
$27K |
| 73610 |
|
221 |
204 |
$26K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
90 |
86 |
$25K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
416 |
115 |
$24K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,977 |
2,526 |
$22K |
| 72100 |
|
119 |
113 |
$13K |
| 36415 |
Collection of venous blood by venipuncture |
1,752 |
1,557 |
$12K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
198 |
85 |
$12K |
| 83880 |
|
459 |
404 |
$12K |
| 73030 |
|
123 |
105 |
$11K |
| 73562 |
|
112 |
95 |
$11K |
| 73130 |
|
163 |
145 |
$11K |
| 73110 |
|
148 |
132 |
$10K |
| 84484 |
|
905 |
775 |
$10K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
110 |
103 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
119 |
113 |
$8K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
50 |
50 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
385 |
369 |
$7K |
| 81001 |
|
1,509 |
1,389 |
$7K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
200 |
170 |
$6K |
| 73630 |
|
95 |
88 |
$6K |
| 80320 |
|
395 |
356 |
$6K |
| 83690 |
|
641 |
570 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
400 |
359 |
$5K |
| 80143 |
|
170 |
157 |
$5K |
| 80179 |
|
168 |
155 |
$5K |
| 84703 |
|
538 |
513 |
$5K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
37 |
37 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
468 |
438 |
$4K |
| 82962 |
|
342 |
259 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
292 |
276 |
$4K |
| 87070 |
|
314 |
296 |
$4K |
| 83605 |
|
293 |
257 |
$3K |
| 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 |
37 |
36 |
$3K |
| 70486 |
|
12 |
12 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
25 |
25 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
112 |
$3K |
| 87040 |
|
156 |
139 |
$2K |
| 83735 |
|
250 |
206 |
$2K |
| 85610 |
|
425 |
384 |
$2K |
| 82550 |
|
205 |
192 |
$2K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
26 |
12 |
$1K |
| 85379 |
|
149 |
134 |
$1K |
| 73502 |
|
15 |
12 |
$952.18 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
73 |
71 |
$917.70 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
26 |
26 |
$538.19 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
250 |
201 |
$451.53 |
| 82553 |
|
52 |
50 |
$443.93 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
27 |
25 |
$392.75 |
| 96368 |
|
12 |
12 |
$365.68 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$361.52 |
| 82140 |
|
15 |
15 |
$275.04 |
| 80061 |
Lipid panel |
18 |
18 |
$256.47 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
26 |
25 |
$251.01 |
| 85027 |
|
40 |
39 |
$219.93 |
| J2704 |
Injection, propofol, 10 mg |
53 |
48 |
$213.43 |
| 87186 |
|
29 |
28 |
$212.98 |
| 96376 |
|
212 |
187 |
$210.54 |
| 87077 |
|
29 |
27 |
$162.68 |
| 81003 |
|
83 |
80 |
$157.68 |
| 85730 |
|
12 |
12 |
$50.34 |
| 85652 |
|
13 |
12 |
$35.24 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
66 |
56 |
$27.93 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
45 |
39 |
$27.87 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
45 |
42 |
$20.97 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
22 |
18 |
$13.21 |
| A9270 |
Non-covered item or service |
22 |
14 |
$0.00 |