| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,741 |
3,323 |
$259K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,217 |
3,487 |
$251K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,812 |
1,371 |
$225K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,678 |
2,201 |
$143K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,045 |
949 |
$86K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
626 |
509 |
$45K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
587 |
470 |
$42K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
346 |
306 |
$27K |
| G0378 |
Hospital observation service, per hour |
996 |
653 |
$15K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
44 |
26 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
104 |
100 |
$2K |
| 76937 |
|
56 |
40 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,017 |
1,567 |
$1K |
| 80053 |
Comprehensive metabolic panel |
1,385 |
1,145 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13 |
13 |
$536.85 |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
596 |
495 |
$527.43 |
| 84484 |
|
628 |
467 |
$523.56 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,783 |
2,221 |
$493.30 |
| A0425 |
Ground mileage, per statute mile |
974 |
797 |
$467.46 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
909 |
711 |
$427.54 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
716 |
496 |
$396.15 |
| 83735 |
|
304 |
232 |
$216.77 |
| 87634 |
|
12 |
12 |
$212.85 |
| 70450 |
Computed tomography, head or brain; without contrast material |
41 |
37 |
$200.24 |
| 81003 |
|
603 |
522 |
$101.34 |
| 71045 |
Radiologic examination, chest; single view |
906 |
719 |
$86.72 |
| 85610 |
|
270 |
210 |
$81.50 |
| 83690 |
|
255 |
217 |
$73.50 |
| 83880 |
|
12 |
12 |
$51.23 |
| 81001 |
|
195 |
177 |
$44.26 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,272 |
1,684 |
$40.76 |
| 86140 |
|
76 |
59 |
$32.51 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13 |
12 |
$23.18 |
| 82550 |
|
14 |
12 |
$18.69 |
| 86900 |
|
46 |
41 |
$18.13 |
| 86901 |
|
46 |
41 |
$18.13 |
| C1769 |
Guide wire |
283 |
222 |
$17.68 |
| 86850 |
|
32 |
28 |
$16.41 |
| 83605 |
|
18 |
12 |
$12.88 |
| 36415 |
Collection of venous blood by venipuncture |
1,265 |
1,054 |
$9.20 |
| 71046 |
Radiologic examination, chest; 2 views |
131 |
117 |
$7.24 |
| C1894 |
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser |
113 |
87 |
$4.21 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,340 |
2,346 |
$4.10 |
| J1644 |
Injection, heparin sodium, per 1000 units |
360 |
210 |
$3.83 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,502 |
1,154 |
$3.50 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
520 |
403 |
$3.30 |
| C1887 |
Catheter, guiding (may include infusion/perfusion capability) |
90 |
66 |
$2.54 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,050 |
813 |
$2.48 |
| A9270 |
Non-covered item or service |
2,593 |
1,339 |
$2.35 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,085 |
1,541 |
$0.51 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
111 |
81 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
931 |
648 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
538 |
437 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
876 |
696 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
121 |
82 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
203 |
180 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
131 |
116 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,102 |
797 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
1,575 |
1,018 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
817 |
676 |
$0.00 |
| 96376 |
|
868 |
565 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,610 |
1,272 |
$0.00 |
| A0434 |
Specialty care transport (sct) |
121 |
101 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
19 |
13 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
462 |
240 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
14 |
13 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
33 |
31 |
$0.00 |