| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,147 |
981 |
$118K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
295 |
277 |
$94K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
764 |
660 |
$82K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,007 |
963 |
$82K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,287 |
1,056 |
$58K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
497 |
274 |
$56K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,176 |
1,142 |
$48K |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
565 |
513 |
$30K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
767 |
743 |
$25K |
| 72141 |
|
703 |
666 |
$22K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
1,031 |
812 |
$14K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,727 |
2,602 |
$11K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
5,756 |
3,769 |
$11K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
570 |
552 |
$10K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
655 |
636 |
$10K |
| 72146 |
|
90 |
88 |
$8K |
| 74183 |
|
253 |
247 |
$8K |
| 73222 |
|
209 |
191 |
$8K |
| 70450 |
Computed tomography, head or brain; without contrast material |
208 |
150 |
$6K |
| J2704 |
Injection, propofol, 10 mg |
4,703 |
4,219 |
$6K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
145 |
124 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
804 |
771 |
$6K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
4,358 |
3,599 |
$5K |
| 76536 |
|
236 |
228 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,032 |
3,146 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,019 |
3,495 |
$3K |
| 76775 |
|
94 |
91 |
$3K |
| 74160 |
|
90 |
76 |
$3K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
2,628 |
2,367 |
$3K |
| 76642 |
|
847 |
811 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
2,679 |
1,838 |
$2K |
| 74018 |
|
209 |
180 |
$2K |
| 81025 |
|
1,213 |
1,019 |
$2K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
477 |
429 |
$2K |
| G0378 |
Hospital observation service, per hour |
231 |
177 |
$2K |
| 93976 |
|
57 |
54 |
$2K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
616 |
598 |
$2K |
| 76830 |
Ultrasound, transvaginal |
584 |
566 |
$1K |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
868 |
683 |
$1K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
169 |
165 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
409 |
356 |
$1K |
| 70486 |
|
82 |
77 |
$933.30 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
830 |
616 |
$785.18 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,694 |
1,268 |
$730.77 |
| 88304 |
|
29 |
25 |
$702.51 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
590 |
487 |
$699.99 |
| 23350 |
|
217 |
195 |
$686.35 |
| D1120 |
Prophylaxis - child |
17 |
14 |
$596.79 |
| D1206 |
Topical application of fluoride varnish |
17 |
14 |
$596.61 |
| 88342 |
|
486 |
458 |
$585.65 |
| 93971 |
|
292 |
277 |
$546.76 |
| 73630 |
|
13 |
12 |
$522.75 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
160 |
130 |
$439.41 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
874 |
557 |
$399.45 |
| 82948 |
|
1,658 |
1,112 |
$119.23 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
195 |
165 |
$38.05 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,533 |
3,948 |
$37.32 |
| 36415 |
Collection of venous blood by venipuncture |
511 |
454 |
$27.84 |
| 80305 |
|
676 |
612 |
$24.94 |
| J3490 |
Unclassified drugs |
80 |
75 |
$16.31 |
| V2632 |
Posterior chamber intraocular lens |
63 |
55 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
47 |
36 |
$0.00 |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
214 |
166 |
$0.00 |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
149 |
145 |
$0.00 |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
26 |
26 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,631 |
1,576 |
$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 |
17 |
15 |
$0.00 |
| C9290 |
Injection, bupivacaine liposome, 1 mg |
95 |
80 |
$0.00 |
| 94760 |
|
27 |
14 |
$0.00 |
| 88307 |
|
154 |
109 |
$0.00 |
| 70491 |
|
17 |
13 |
$0.00 |
| 73221 |
|
24 |
24 |
$0.00 |
| 64483 |
|
23 |
17 |
$0.00 |
| 64493 |
|
18 |
13 |
$0.00 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
26 |
12 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
15 |
15 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
12 |
$0.00 |
| A4648 |
Tissue marker, implantable, any type, each |
12 |
12 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
32 |
31 |
$0.00 |
| 77065 |
Tomosynthesis, mammo |
360 |
312 |
$0.00 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
837 |
796 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
603 |
377 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,631 |
1,576 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
207 |
185 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
311 |
289 |
$0.00 |
| 71250 |
|
448 |
436 |
$0.00 |
| 72110 |
|
13 |
12 |
$0.00 |
| 96101 |
|
50 |
46 |
$0.00 |
| 82565 |
|
31 |
25 |
$0.00 |
| 77080 |
|
160 |
158 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
72 |
65 |
$0.00 |
| C1780 |
Lens, intraocular (new technology) |
168 |
130 |
$0.00 |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
271 |
264 |
$0.00 |
| 72156 |
|
13 |
12 |
$0.00 |
| 64640 |
|
86 |
14 |
$0.00 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
51 |
50 |
$0.00 |
| 98927 |
|
12 |
12 |
$0.00 |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
43 |
42 |
$0.00 |
| 96136 |
|
13 |
13 |
$0.00 |