| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,577 |
2,035 |
$325K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,232 |
1,182 |
$240K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,635 |
1,564 |
$240K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,106 |
1,102 |
$164K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,107 |
1,067 |
$163K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
552 |
528 |
$162K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,940 |
2,910 |
$117K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,544 |
743 |
$111K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
539 |
518 |
$105K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
326 |
302 |
$82K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
455 |
454 |
$67K |
| T1030 |
Nursing care, in the home, by registered nurse, per diem |
361 |
111 |
$63K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
187 |
183 |
$52K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
205 |
198 |
$49K |
| 92552 |
|
716 |
716 |
$48K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
158 |
101 |
$42K |
| D1110 |
Prophylaxis - adult |
1,010 |
1,009 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
224 |
206 |
$34K |
| 99173 |
|
520 |
520 |
$33K |
| G0378 |
Hospital observation service, per hour |
164 |
135 |
$33K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,588 |
1,471 |
$33K |
| 70450 |
Computed tomography, head or brain; without contrast material |
115 |
112 |
$32K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
203 |
166 |
$29K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
830 |
784 |
$28K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
414 |
368 |
$26K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
148 |
142 |
$25K |
| 99177 |
|
276 |
276 |
$24K |
| D0120 |
Periodic oral evaluation - established patient |
1,071 |
1,070 |
$23K |
| 80053 |
Comprehensive metabolic panel |
683 |
590 |
$23K |
| 80076 |
|
784 |
737 |
$23K |
| D1120 |
Prophylaxis - child |
537 |
537 |
$18K |
| 86901 |
|
554 |
521 |
$18K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
102 |
102 |
$18K |
| 86900 |
|
554 |
521 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
102 |
87 |
$17K |
| 93975 |
|
34 |
33 |
$15K |
| J3490 |
Unclassified drugs |
675 |
505 |
$14K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
32 |
31 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
178 |
124 |
$12K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
315 |
309 |
$11K |
| 99174 |
|
185 |
184 |
$11K |
| 96415 |
|
13 |
12 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
79 |
63 |
$10K |
| 86850 |
|
547 |
514 |
$10K |
| D7140 |
Extraction, erupted tooth or exposed root |
228 |
200 |
$10K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
357 |
347 |
$9K |
| 36415 |
Collection of venous blood by venipuncture |
3,215 |
2,769 |
$9K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
347 |
337 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,302 |
2,895 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
54 |
$8K |
| 87486 |
|
347 |
337 |
$7K |
| 87581 |
|
347 |
337 |
$7K |
| 86780 |
|
219 |
217 |
$7K |
| 83655 |
|
436 |
435 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
753 |
648 |
$6K |
| G0379 |
Direct admission of patient for hospital observation care |
125 |
100 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
40 |
36 |
$6K |
| D0274 |
Bitewings - four radiographic images |
277 |
276 |
$6K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
587 |
522 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
559 |
554 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
199 |
199 |
$5K |
| 81025 |
|
1,178 |
1,115 |
$5K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13 |
13 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
409 |
403 |
$4K |
| D1206 |
Topical application of fluoride varnish |
226 |
226 |
$4K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
121 |
121 |
$4K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
23 |
23 |
$3K |
| 59025 |
Fetal non-stress test |
16 |
12 |
$3K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
493 |
459 |
$3K |
| 87040 |
|
248 |
243 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
343 |
332 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
627 |
611 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
315 |
309 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,266 |
1,169 |
$2K |
| 88142 |
|
66 |
66 |
$2K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
216 |
208 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$2K |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
14 |
14 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
331 |
275 |
$2K |
| 80061 |
Lipid panel |
125 |
121 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
470 |
439 |
$2K |
| 81001 |
|
1,545 |
1,471 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
700 |
672 |
$2K |
| 84702 |
|
232 |
216 |
$2K |
| 86701 |
|
155 |
154 |
$2K |
| 90670 |
|
1,113 |
1,112 |
$1K |
| 90647 |
|
1,104 |
1,102 |
$1K |
| 90686 |
|
765 |
764 |
$1K |
| 90723 |
|
864 |
862 |
$982.67 |
| 87510 |
|
31 |
29 |
$951.52 |
| 90633 |
|
528 |
527 |
$929.10 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
55 |
53 |
$929.09 |
| 90715 |
|
87 |
87 |
$884.05 |
| D0272 |
Bitewings - two radiographic images |
69 |
69 |
$883.54 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$873.12 |
| 90651 |
|
125 |
125 |
$833.89 |
| 90680 |
|
816 |
814 |
$823.80 |
| 85610 |
|
530 |
477 |
$819.45 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
14 |
13 |
$805.90 |
| 90685 |
|
632 |
631 |
$786.29 |
| D0210 |
Intraoral - complete series of radiographic images |
29 |
29 |
$785.40 |
| 87660 |
|
31 |
29 |
$779.17 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
168 |
160 |
$758.78 |
| 84439 |
|
139 |
136 |
$709.57 |
| J7050 |
Infusion, normal saline solution, 250 cc |
226 |
184 |
$697.27 |
| 84443 |
Thyroid stimulating hormone (TSH) |
108 |
104 |
$643.55 |
| 80069 |
|
36 |
20 |
$627.09 |
| 84484 |
|
385 |
339 |
$570.95 |
| 83690 |
|
614 |
582 |
$551.28 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
39 |
32 |
$542.95 |
| 87081 |
|
327 |
311 |
$542.23 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
318 |
226 |
$521.04 |
| 88342 |
|
24 |
24 |
$514.66 |
| 82150 |
|
474 |
446 |
$491.54 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
13 |
12 |
$485.06 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
12 |
12 |
$461.38 |
| 85027 |
|
80 |
61 |
$455.18 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
14 |
12 |
$444.50 |
| 85730 |
|
507 |
476 |
$441.48 |
| 83735 |
|
403 |
301 |
$418.05 |
| 90716 |
|
197 |
196 |
$393.59 |
| 90707 |
|
178 |
178 |
$357.89 |
| 81002 |
|
497 |
347 |
$336.01 |
| 82550 |
|
287 |
253 |
$321.01 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
26 |
24 |
$309.32 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
18 |
15 |
$309.01 |
| 90700 |
|
210 |
210 |
$293.81 |
| D0230 |
Intraoral - periapical each additional radiographic image |
46 |
45 |
$274.50 |
| 87340 |
|
56 |
56 |
$248.99 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
107 |
99 |
$224.15 |
| 87480 |
|
31 |
29 |
$224.11 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
312 |
303 |
$189.13 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
85 |
81 |
$184.66 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
738 |
693 |
$173.44 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
385 |
366 |
$158.22 |
| 86140 |
|
155 |
143 |
$152.95 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
494 |
474 |
$151.66 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
377 |
333 |
$145.22 |
| 90696 |
|
72 |
71 |
$107.99 |
| 90710 |
|
84 |
83 |
$107.99 |
| 90734 |
|
55 |
55 |
$107.10 |
| 85652 |
|
131 |
121 |
$79.40 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
100 |
89 |
$78.56 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
289 |
282 |
$77.30 |
| 73610 |
|
14 |
12 |
$75.10 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
390 |
201 |
$46.70 |
| 82728 |
|
16 |
16 |
$44.25 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
78 |
78 |
$41.97 |
| 83540 |
|
35 |
33 |
$40.24 |
| 82248 |
|
29 |
23 |
$38.91 |
| 83550 |
|
31 |
31 |
$35.21 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
208 |
205 |
$18.88 |
| 84550 |
|
22 |
16 |
$15.09 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
12 |
12 |
$14.63 |
| 84100 |
|
42 |
34 |
$10.06 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
243 |
218 |
$5.40 |
| 83615 |
|
20 |
15 |
$5.03 |
| 71045 |
Radiologic examination, chest; single view |
22 |
22 |
$4.31 |
| 36416 |
|
68 |
59 |
$0.00 |
| 83605 |
|
14 |
14 |
$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 |
32 |
32 |
$0.00 |
| 99080 |
|
376 |
130 |
$0.00 |