| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
532 |
497 |
$170K |
| 0450 |
Emergency room services |
1,207 |
1,137 |
$27K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
73 |
61 |
$5K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
306 |
228 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
75 |
74 |
$4K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
51 |
50 |
$4K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
178 |
165 |
$3K |
| Z7502 |
|
77 |
76 |
$3K |
| 80053 |
Comprehensive metabolic panel |
639 |
603 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
740 |
693 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
447 |
437 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
110 |
105 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
75 |
74 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
150 |
144 |
$1K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
67 |
65 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
395 |
248 |
$1K |
| 99199 |
Unlisted special service, procedure or report |
22 |
20 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
119 |
117 |
$1K |
| J3490 |
Unclassified drugs |
914 |
527 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
112 |
106 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
62 |
62 |
$974.89 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
120 |
102 |
$967.20 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
135 |
132 |
$790.97 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
165 |
165 |
$782.48 |
| 81001 |
|
529 |
504 |
$774.34 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
165 |
152 |
$679.38 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
22 |
22 |
$639.70 |
| 0324 |
|
65 |
64 |
$606.69 |
| Z7610 |
|
49 |
29 |
$599.88 |
| 71046 |
Radiologic examination, chest; 2 views |
155 |
154 |
$587.83 |
| 84484 |
|
106 |
87 |
$485.24 |
| 84443 |
Thyroid stimulating hormone (TSH) |
100 |
100 |
$484.54 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
14 |
$474.28 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
21 |
20 |
$454.61 |
| 83690 |
|
154 |
146 |
$426.29 |
| 80061 |
Lipid panel |
134 |
133 |
$413.42 |
| 81025 |
|
248 |
237 |
$390.76 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
103 |
100 |
$274.96 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
133 |
132 |
$273.89 |
| 99000 |
|
317 |
304 |
$268.62 |
| 82150 |
|
108 |
103 |
$265.75 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
87 |
83 |
$256.12 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
131 |
126 |
$226.02 |
| 71045 |
Radiologic examination, chest; single view |
88 |
81 |
$221.41 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
48 |
47 |
$195.86 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
35 |
25 |
$172.36 |
| 83605 |
|
18 |
15 |
$108.32 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
12 |
12 |
$107.27 |
| 85610 |
|
88 |
72 |
$106.07 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
29 |
27 |
$103.91 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
26 |
26 |
$96.75 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
44 |
42 |
$65.27 |
| 85730 |
|
41 |
41 |
$61.56 |
| 87420 |
|
13 |
13 |
$60.72 |
| 83735 |
|
26 |
26 |
$37.45 |
| 85651 |
|
33 |
30 |
$29.43 |
| 84479 |
|
22 |
22 |
$5.68 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
13 |
13 |
$4.48 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
33 |
25 |
$0.75 |
| 86171 |
|
21 |
17 |
$0.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
12 |
12 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
147 |
88 |
$0.00 |