| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,389 |
2,280 |
$417K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,184 |
2,081 |
$392K |
| G0378 |
Hospital observation service, per hour |
410 |
264 |
$336K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
741 |
733 |
$98K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
511 |
159 |
$80K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
622 |
614 |
$61K |
| T1015 |
Clinic visit/encounter, all-inclusive |
529 |
168 |
$59K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
408 |
392 |
$50K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
177 |
172 |
$27K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
259 |
253 |
$23K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
50 |
50 |
$19K |
| 95811 |
|
38 |
38 |
$18K |
| 36000 |
|
188 |
182 |
$16K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
622 |
613 |
$16K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
263 |
252 |
$11K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
40 |
40 |
$8K |
| 71046 |
Radiologic examination, chest; 2 views |
524 |
509 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,653 |
1,573 |
$7K |
| 0001A |
|
148 |
148 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,407 |
1,205 |
$5K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
133 |
77 |
$5K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
784 |
721 |
$4K |
| 94729 |
|
93 |
93 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
225 |
221 |
$3K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
538 |
508 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
50 |
48 |
$3K |
| 0002A |
|
48 |
48 |
$3K |
| 94726 |
|
78 |
78 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
14 |
14 |
$2K |
| 94060 |
|
109 |
109 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,409 |
1,227 |
$2K |
| 76536 |
|
26 |
26 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
271 |
233 |
$1K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
195 |
191 |
$1K |
| 85027 |
|
186 |
172 |
$1K |
| 85730 |
|
297 |
291 |
$964.96 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
26 |
26 |
$962.66 |
| 73630 |
|
82 |
72 |
$906.26 |
| 76770 |
|
13 |
13 |
$796.52 |
| 71045 |
Radiologic examination, chest; single view |
298 |
291 |
$757.60 |
| 84484 |
|
374 |
332 |
$710.52 |
| 72100 |
|
27 |
26 |
$683.36 |
| 0004A |
|
12 |
12 |
$651.34 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
67 |
63 |
$636.41 |
| 80076 |
|
349 |
326 |
$570.75 |
| 85610 |
|
318 |
311 |
$563.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
106 |
90 |
$497.15 |
| 76642 |
|
12 |
12 |
$474.26 |
| 73130 |
|
34 |
29 |
$466.81 |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$453.25 |
| 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 |
42 |
42 |
$421.00 |
| 72110 |
|
13 |
13 |
$401.51 |
| 80053 |
Comprehensive metabolic panel |
135 |
132 |
$384.21 |
| 83690 |
|
328 |
306 |
$344.76 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$334.61 |
| 72050 |
|
12 |
12 |
$295.57 |
| 83735 |
|
207 |
182 |
$230.25 |
| 81003 |
|
303 |
295 |
$222.19 |
| 86900 |
|
56 |
55 |
$205.86 |
| 81001 |
|
176 |
168 |
$158.27 |
| A9270 |
Non-covered item or service |
2,818 |
876 |
$154.54 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
77 |
75 |
$144.00 |
| 73110 |
|
13 |
12 |
$136.43 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
202 |
182 |
$69.13 |
| 87088 |
|
26 |
25 |
$49.06 |
| 84443 |
Thyroid stimulating hormone (TSH) |
16 |
15 |
$46.42 |
| J2704 |
Injection, propofol, 10 mg |
670 |
651 |
$40.71 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,828 |
1,602 |
$30.40 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,488 |
1,325 |
$23.12 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
898 |
681 |
$18.70 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
339 |
273 |
$15.89 |
| 36415 |
Collection of venous blood by venipuncture |
86 |
75 |
$15.86 |
| 82962 |
|
78 |
56 |
$14.26 |
| 84703 |
|
16 |
15 |
$10.26 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
730 |
704 |
$4.20 |
| J3490 |
Unclassified drugs |
1,542 |
912 |
$4.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
848 |
766 |
$1.87 |
| 91300 |
|
26 |
26 |
$0.04 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
285 |
272 |
$0.00 |
| 96376 |
|
36 |
24 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
98 |
81 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
399 |
306 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
33 |
24 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
75 |
54 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
62 |
57 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
90 |
87 |
$0.00 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
59 |
45 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
33 |
26 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
14 |
13 |
$0.00 |
| S0028 |
Injection, famotidine, 20 mg |
13 |
13 |
$0.00 |