| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,487 |
15,235 |
$2.87M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,077 |
19,998 |
$1.13M |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
6,035 |
5,792 |
$875K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,621 |
2,389 |
$515K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,199 |
1,253 |
$384K |
| 71045 |
Radiologic examination, chest; single view |
7,235 |
6,698 |
$202K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
10,379 |
9,919 |
$178K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
879 |
840 |
$164K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,996 |
1,661 |
$159K |
| 80053 |
Comprehensive metabolic panel |
12,368 |
10,974 |
$158K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20,183 |
17,796 |
$146K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,872 |
1,824 |
$144K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
4,055 |
3,602 |
$105K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,233 |
1,166 |
$78K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
615 |
538 |
$60K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,895 |
1,838 |
$55K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,067 |
1,029 |
$51K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,232 |
400 |
$50K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
352 |
327 |
$44K |
| 76801 |
|
630 |
533 |
$44K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
927 |
904 |
$43K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
970 |
932 |
$42K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,750 |
1,671 |
$41K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,628 |
1,566 |
$39K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,387 |
1,349 |
$36K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
65 |
12 |
$31K |
| 83880 |
|
1,595 |
1,438 |
$31K |
| 87800 |
|
821 |
799 |
$26K |
| 81001 |
|
8,551 |
7,852 |
$25K |
| 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 |
457 |
427 |
$24K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
275 |
267 |
$24K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,319 |
3,018 |
$24K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
179 |
173 |
$23K |
| 84484 |
|
3,149 |
2,431 |
$22K |
| CP007 |
|
497 |
385 |
$22K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
5,702 |
4,781 |
$20K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
548 |
517 |
$19K |
| 93976 |
|
284 |
258 |
$16K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,406 |
2,059 |
$16K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
667 |
348 |
$16K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
545 |
179 |
$15K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
943 |
921 |
$15K |
| 84703 |
|
2,425 |
2,266 |
$15K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,061 |
1,838 |
$13K |
| 81025 |
|
1,835 |
1,771 |
$12K |
| 84702 |
|
1,158 |
913 |
$12K |
| 83690 |
|
2,842 |
2,570 |
$12K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
196 |
164 |
$11K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
764 |
731 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,546 |
1,085 |
$11K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
220 |
214 |
$9K |
| 93975 |
|
43 |
40 |
$7K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
360 |
346 |
$7K |
| 86780 |
|
768 |
734 |
$6K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,395 |
1,274 |
$6K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
110 |
107 |
$6K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
706 |
640 |
$5K |
| 86850 |
|
350 |
339 |
$5K |
| 87634 |
|
77 |
74 |
$5K |
| 83735 |
|
1,221 |
923 |
$5K |
| 83605 |
|
606 |
454 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
856 |
799 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
60 |
59 |
$4K |
| 82947 |
|
984 |
597 |
$4K |
| 85730 |
|
977 |
912 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
84 |
77 |
$3K |
| 97161 |
|
57 |
53 |
$3K |
| 85610 |
|
1,259 |
1,158 |
$3K |
| 87040 |
|
435 |
209 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
48 |
48 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
740 |
665 |
$3K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
1,926 |
1,584 |
$3K |
| 94760 |
|
114 |
68 |
$3K |
| 86900 |
|
1,284 |
1,095 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,148 |
2,743 |
$3K |
| 82951 |
|
297 |
284 |
$3K |
| 86901 |
|
1,193 |
1,094 |
$2K |
| 99205 |
Prolong outpt/office vis |
38 |
38 |
$2K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
115 |
113 |
$2K |
| 80076 |
|
252 |
237 |
$2K |
| 85379 |
|
483 |
466 |
$2K |
| 84145 |
|
59 |
56 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
25 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
253 |
218 |
$1K |
| 86803 |
|
166 |
159 |
$1K |
| 96376 |
|
113 |
105 |
$1K |
| 81003 |
|
885 |
826 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
209 |
205 |
$1K |
| 85027 |
|
264 |
217 |
$1K |
| 86762 |
|
139 |
133 |
$1K |
| 90715 |
|
110 |
107 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,210 |
1,123 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
55 |
54 |
$906.51 |
| 87340 |
|
125 |
120 |
$824.65 |
| 36415 |
Collection of venous blood by venipuncture |
3,091 |
2,610 |
$649.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
110 |
107 |
$636.70 |
| 86787 |
|
92 |
88 |
$621.75 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
144 |
130 |
$609.07 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
542 |
513 |
$575.25 |
| 83021 |
|
57 |
55 |
$529.92 |
| 90686 |
|
143 |
142 |
$482.20 |
| 73562 |
|
12 |
12 |
$413.05 |
| 71046 |
Radiologic examination, chest; 2 views |
14 |
13 |
$366.16 |
| 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 |
638 |
606 |
$365.22 |
| 0352U |
|
110 |
99 |
$333.87 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
125 |
122 |
$308.98 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
325 |
281 |
$228.10 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
301 |
285 |
$202.29 |
| J2060 |
Injection, lorazepam, 2 mg |
71 |
53 |
$136.28 |
| 80047 |
|
17 |
17 |
$110.98 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
315 |
290 |
$102.30 |
| 81511 |
|
13 |
13 |
$94.70 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
109 |
96 |
$92.95 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
16 |
16 |
$87.12 |
| 85014 |
|
34 |
30 |
$83.85 |
| 90656 |
|
17 |
17 |
$70.64 |
| 86140 |
|
15 |
12 |
$68.57 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
99 |
98 |
$55.41 |
| 84100 |
|
31 |
28 |
$37.55 |
| 82550 |
|
15 |
14 |
$23.41 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
13 |
12 |
$5.87 |
| A9270 |
Non-covered item or service |
7,025 |
6,460 |
$2.39 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
15 |
13 |
$2.38 |
| J2704 |
Injection, propofol, 10 mg |
18 |
15 |
$0.00 |