| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,116 |
1,082 |
$232K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
914 |
879 |
$210K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
634 |
603 |
$147K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
237 |
213 |
$122K |
| 59025 |
Fetal non-stress test |
210 |
114 |
$65K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
202 |
199 |
$35K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
185 |
184 |
$34K |
| 70450 |
Computed tomography, head or brain; without contrast material |
129 |
124 |
$20K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
484 |
474 |
$16K |
| 93975 |
|
87 |
86 |
$13K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
104 |
84 |
$12K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
56 |
54 |
$11K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
55 |
54 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
967 |
475 |
$10K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
31 |
31 |
$10K |
| ATP14 |
|
792 |
749 |
$9K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
78 |
76 |
$9K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
137 |
50 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,199 |
1,113 |
$7K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
145 |
136 |
$7K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
37 |
37 |
$6K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
35 |
35 |
$6K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
80 |
59 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
13 |
12 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
538 |
530 |
$4K |
| 10060 |
|
12 |
12 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
60 |
59 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
39 |
39 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
209 |
209 |
$3K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
91 |
39 |
$3K |
| 84484 |
|
449 |
248 |
$3K |
| 84702 |
|
208 |
190 |
$3K |
| 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 |
103 |
96 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
14 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
14 |
14 |
$2K |
| 76801 |
|
61 |
56 |
$2K |
| ATP08 |
|
205 |
201 |
$2K |
| 81025 |
|
255 |
252 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
229 |
217 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
13 |
$2K |
| 83690 |
|
269 |
258 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
39 |
39 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
52 |
51 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
52 |
51 |
$1K |
| 87807 |
|
129 |
126 |
$1K |
| 97161 |
|
15 |
15 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
66 |
62 |
$1K |
| 76830 |
Ultrasound, transvaginal |
35 |
34 |
$1K |
| 81001 |
|
420 |
398 |
$1K |
| 84703 |
|
173 |
171 |
$1K |
| 87081 |
|
189 |
189 |
$1K |
| 74018 |
|
31 |
31 |
$985.92 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
29 |
29 |
$773.50 |
| 81003 |
|
401 |
396 |
$706.45 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
77 |
51 |
$674.45 |
| G0378 |
Hospital observation service, per hour |
52 |
27 |
$668.62 |
| 85379 |
|
77 |
77 |
$664.52 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
204 |
193 |
$629.73 |
| 86850 |
|
76 |
72 |
$612.02 |
| 80050 |
General health panel |
34 |
34 |
$564.80 |
| 83880 |
|
16 |
16 |
$553.92 |
| ATP15 |
|
46 |
46 |
$521.64 |
| 83605 |
|
38 |
36 |
$346.80 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
14 |
14 |
$339.30 |
| 85610 |
|
96 |
94 |
$336.42 |
| 90715 |
|
13 |
13 |
$328.12 |
| 87077 |
|
48 |
46 |
$320.85 |
| 87040 |
|
56 |
32 |
$309.40 |
| 72100 |
|
18 |
18 |
$303.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
27 |
$297.36 |
| 87186 |
|
40 |
38 |
$289.94 |
| 83735 |
|
48 |
44 |
$277.77 |
| 93971 |
|
12 |
12 |
$271.16 |
| 86900 |
|
102 |
95 |
$250.80 |
| 86901 |
|
102 |
95 |
$250.80 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
31 |
30 |
$239.82 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
397 |
382 |
$239.33 |
| 80053 |
Comprehensive metabolic panel |
904 |
856 |
$217.12 |
| 82607 |
|
14 |
14 |
$186.20 |
| 88304 |
|
19 |
18 |
$163.16 |
| 85027 |
|
30 |
28 |
$159.88 |
| 82746 |
|
12 |
12 |
$155.52 |
| 73630 |
|
42 |
41 |
$151.68 |
| 73030 |
|
22 |
21 |
$151.68 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
309 |
252 |
$149.40 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
123 |
105 |
$149.40 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
83 |
69 |
$149.40 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
42 |
42 |
$149.40 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
351 |
329 |
$149.40 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$102.72 |
| 82947 |
|
106 |
90 |
$100.63 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
347 |
320 |
$99.42 |
| 85007 |
|
30 |
28 |
$97.15 |
| 85730 |
|
17 |
17 |
$84.80 |
| 73130 |
|
25 |
25 |
$75.84 |
| 73562 |
|
19 |
19 |
$75.84 |
| 71045 |
Radiologic examination, chest; single view |
112 |
110 |
$75.84 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
471 |
434 |
$69.97 |
| 85652 |
|
16 |
15 |
$26.18 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
414 |
348 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
74 |
45 |
$0.00 |
| 73610 |
|
60 |
59 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
114 |
104 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
16 |
13 |
$0.00 |
| 80143 |
|
18 |
18 |
$0.00 |
| 80061 |
Lipid panel |
19 |
19 |
$0.00 |
| 82565 |
|
13 |
13 |
$0.00 |
| 80076 |
|
38 |
37 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
80 |
76 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
96 |
82 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
119 |
112 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
19 |
16 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
95 |
60 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
92 |
89 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
271 |
260 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
95 |
92 |
$0.00 |
| 96376 |
|
27 |
24 |
$0.00 |