| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
17,462 |
14,191 |
$4.15M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
10,122 |
8,543 |
$1.39M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,459 |
1,714 |
$545K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,011 |
1,633 |
$340K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,155 |
926 |
$250K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
7,761 |
5,731 |
$217K |
| G0378 |
Hospital observation service, per hour |
1,363 |
794 |
$207K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,965 |
765 |
$184K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,221 |
1,278 |
$175K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,353 |
1,196 |
$168K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
341 |
272 |
$166K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,782 |
1,412 |
$163K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
381 |
341 |
$155K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,385 |
3,655 |
$153K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,296 |
2,758 |
$133K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,777 |
1,141 |
$133K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20,608 |
15,394 |
$124K |
| 36415 |
Collection of venous blood by venipuncture |
45,352 |
21,130 |
$120K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,097 |
936 |
$110K |
| 80053 |
Comprehensive metabolic panel |
20,313 |
13,046 |
$106K |
| 71046 |
Radiologic examination, chest; 2 views |
5,147 |
4,292 |
$106K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
404 |
359 |
$105K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
879 |
796 |
$103K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,337 |
4,759 |
$103K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,205 |
1,086 |
$102K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,654 |
2,180 |
$102K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
903 |
805 |
$91K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
625 |
529 |
$86K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
823 |
758 |
$86K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
477 |
347 |
$79K |
| 81001 |
|
10,502 |
8,629 |
$70K |
| 99218 |
|
1,003 |
391 |
$69K |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
536 |
417 |
$68K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,204 |
4,475 |
$68K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
5,498 |
4,485 |
$60K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,052 |
846 |
$57K |
| 71045 |
Radiologic examination, chest; single view |
2,554 |
1,874 |
$53K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
94 |
90 |
$46K |
| 80055 |
|
957 |
824 |
$44K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,155 |
803 |
$44K |
| 73630 |
|
2,261 |
1,808 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,542 |
1,453 |
$42K |
| 80061 |
Lipid panel |
3,824 |
3,158 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
845 |
829 |
$37K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,463 |
3,848 |
$34K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,379 |
1,864 |
$32K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,666 |
568 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,104 |
996 |
$30K |
| 81025 |
|
3,048 |
2,651 |
$30K |
| 73610 |
|
1,562 |
1,207 |
$29K |
| 87070 |
|
6,467 |
4,673 |
$28K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,268 |
1,404 |
$26K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,340 |
4,148 |
$25K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,221 |
1,001 |
$24K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,981 |
1,646 |
$24K |
| 76536 |
|
243 |
216 |
$22K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
5,665 |
3,612 |
$21K |
| 64493 |
|
54 |
44 |
$21K |
| 73110 |
|
1,384 |
978 |
$20K |
| 73030 |
|
1,040 |
847 |
$20K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
921 |
682 |
$20K |
| 86769 |
|
1,095 |
572 |
$20K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,970 |
2,497 |
$20K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
80 |
73 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,049 |
3,664 |
$19K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,459 |
2,631 |
$18K |
| 73221 |
|
40 |
38 |
$17K |
| 74018 |
|
940 |
806 |
$17K |
| 87186 |
|
2,145 |
1,814 |
$17K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,170 |
851 |
$16K |
| 73130 |
|
1,062 |
838 |
$16K |
| 82607 |
|
1,501 |
1,172 |
$16K |
| 97162 |
|
340 |
252 |
$16K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
85 |
41 |
$15K |
| 84484 |
|
3,241 |
2,347 |
$14K |
| 84439 |
|
1,703 |
1,496 |
$13K |
| 84702 |
|
1,297 |
836 |
$13K |
| 87040 |
|
1,350 |
1,131 |
$13K |
| 12001 |
|
119 |
116 |
$12K |
| 82728 |
|
1,158 |
955 |
$12K |
| 82746 |
|
968 |
849 |
$12K |
| 83880 |
|
865 |
689 |
$11K |
| 72100 |
|
559 |
449 |
$11K |
| 82248 |
|
4,976 |
3,979 |
$11K |
| 86803 |
|
934 |
793 |
$11K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,063 |
815 |
$11K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
30 |
29 |
$11K |
| 82948 |
|
1,550 |
863 |
$10K |
| 93017 |
|
104 |
100 |
$10K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,124 |
858 |
$10K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
516 |
449 |
$10K |
| 82553 |
|
2,136 |
1,505 |
$10K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
98 |
87 |
$10K |
| 96376 |
|
642 |
395 |
$9K |
| 73562 |
|
574 |
475 |
$9K |
| 85379 |
|
1,809 |
1,503 |
$9K |
| 71250 |
|
49 |
43 |
$8K |
| 83690 |
|
2,749 |
2,307 |
$8K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
311 |
189 |
$8K |
| 73502 |
|
440 |
363 |
$8K |
| 86140 |
|
3,279 |
2,787 |
$7K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,487 |
3,687 |
$7K |
| 62323 |
|
12 |
12 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
761 |
679 |
$6K |
| 90715 |
|
316 |
287 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
177 |
171 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
183 |
176 |
$6K |
| 83605 |
|
1,632 |
1,308 |
$6K |
| 83735 |
|
1,453 |
1,172 |
$6K |
| 85610 |
|
2,300 |
1,425 |
$5K |
| 85730 |
|
948 |
776 |
$5K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
688 |
570 |
$5K |
| 87088 |
|
1,250 |
1,063 |
$5K |
| 87077 |
|
857 |
745 |
$5K |
| 78227 |
|
19 |
13 |
$4K |
| 72110 |
|
147 |
128 |
$4K |
| 80081 |
|
56 |
50 |
$4K |
| 74022 |
|
131 |
117 |
$4K |
| 73560 |
|
277 |
221 |
$4K |
| 70486 |
|
31 |
25 |
$4K |
| 96523 |
|
112 |
101 |
$4K |
| 82950 |
|
824 |
725 |
$4K |
| 85018 |
|
861 |
737 |
$3K |
| 93880 |
|
30 |
28 |
$3K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
148 |
128 |
$3K |
| 76642 |
|
36 |
32 |
$3K |
| 73590 |
|
129 |
104 |
$3K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
44 |
13 |
$3K |
| J2704 |
Injection, propofol, 10 mg |
1,019 |
812 |
$2K |
| 90686 |
|
248 |
227 |
$2K |
| 80320 |
|
510 |
460 |
$2K |
| 86757 |
|
103 |
92 |
$2K |
| 76801 |
|
45 |
37 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
55 |
48 |
$2K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
18 |
13 |
$2K |
| 76830 |
Ultrasound, transvaginal |
29 |
28 |
$2K |
| 97014 |
|
205 |
77 |
$2K |
| 85045 |
|
656 |
565 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,707 |
1,436 |
$2K |
| 86900 |
|
439 |
338 |
$2K |
| 87807 |
|
488 |
457 |
$2K |
| 83516 |
|
77 |
64 |
$2K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
317 |
302 |
$2K |
| 85651 |
|
646 |
534 |
$2K |
| 82550 |
|
649 |
489 |
$2K |
| 82803 |
|
235 |
200 |
$2K |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
332 |
300 |
$2K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
247 |
235 |
$2K |
| 73140 |
|
123 |
107 |
$1K |
| 76770 |
|
15 |
14 |
$1K |
| 86618 |
|
112 |
103 |
$1K |
| 85014 |
|
865 |
735 |
$1K |
| 84153 |
|
108 |
90 |
$1K |
| 86666 |
|
51 |
42 |
$1K |
| 72131 |
|
16 |
16 |
$1K |
| 72040 |
|
57 |
53 |
$1K |
| 82247 |
|
263 |
140 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
386 |
294 |
$1K |
| 84550 |
|
411 |
315 |
$1K |
| 82570 |
|
237 |
200 |
$1K |
| J3490 |
Unclassified drugs |
8,633 |
3,658 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
83 |
65 |
$1K |
| 80074 |
|
37 |
36 |
$1K |
| 59025 |
Fetal non-stress test |
26 |
12 |
$1K |
| 73090 |
|
104 |
94 |
$1K |
| 95816 |
|
14 |
14 |
$990.26 |
| 84146 |
|
58 |
50 |
$944.10 |
| J7050 |
Infusion, normal saline solution, 250 cc |
302 |
93 |
$922.42 |
| 72070 |
|
68 |
50 |
$919.53 |
| 74019 |
|
32 |
31 |
$903.15 |
| 87339 |
|
16 |
13 |
$901.25 |
| 84481 |
|
53 |
51 |
$895.82 |
| A4217 |
Sterile water/saline, 500 ml |
137 |
121 |
$889.54 |
| 86850 |
|
185 |
142 |
$682.55 |
| 84703 |
|
159 |
144 |
$675.04 |
| 72081 |
|
30 |
28 |
$668.48 |
| 97161 |
|
15 |
13 |
$659.59 |
| 83540 |
|
136 |
112 |
$655.25 |
| 87046 |
|
29 |
27 |
$642.26 |
| 84436 |
|
109 |
98 |
$630.13 |
| 82565 |
|
165 |
107 |
$593.73 |
| 86038 |
|
58 |
52 |
$592.29 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
24 |
24 |
$570.88 |
| 86376 |
|
43 |
37 |
$566.59 |
| 83550 |
|
77 |
66 |
$565.51 |
| 80329 |
|
41 |
38 |
$561.37 |
| 73564 |
|
16 |
14 |
$550.78 |
| 71101 |
|
18 |
15 |
$543.08 |
| 36600 |
|
164 |
142 |
$524.81 |
| 82043 |
|
107 |
91 |
$487.47 |
| 82150 |
|
132 |
125 |
$480.74 |
| 73565 |
|
39 |
38 |
$464.20 |
| 82274 |
|
42 |
40 |
$375.21 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
261 |
199 |
$367.93 |
| 72050 |
|
16 |
12 |
$358.84 |
| 93226 |
|
13 |
12 |
$357.42 |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
46 |
41 |
$321.57 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
148 |
135 |
$319.64 |
| 73070 |
|
14 |
12 |
$307.62 |
| 84450 |
|
61 |
53 |
$304.12 |
| 64494 |
|
46 |
42 |
$294.24 |
| 87045 |
|
50 |
41 |
$291.35 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
55 |
52 |
$274.81 |
| 80076 |
|
34 |
28 |
$196.07 |
| A9537 |
Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
14 |
13 |
$177.23 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
125 |
116 |
$164.70 |
| 84520 |
|
67 |
53 |
$160.90 |
| 84156 |
|
50 |
42 |
$160.15 |
| 83874 |
|
39 |
32 |
$133.56 |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
13 |
13 |
$97.69 |
| 84479 |
|
14 |
13 |
$75.24 |
| 84460 |
|
24 |
12 |
$60.84 |
| 86308 |
|
13 |
12 |
$35.52 |
| A9270 |
Non-covered item or service |
231 |
152 |
$0.00 |