| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,509 |
4,012 |
$1.68M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
7,719 |
7,052 |
$1.44M |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,888 |
3,514 |
$122K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
166 |
152 |
$99K |
| G0378 |
Hospital observation service, per hour |
69 |
49 |
$77K |
| 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 |
975 |
929 |
$68K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
11,933 |
10,200 |
$64K |
| 80050 |
General health panel |
1,474 |
1,381 |
$62K |
| 80053 |
Comprehensive metabolic panel |
7,953 |
6,921 |
$60K |
| 36415 |
Collection of venous blood by venipuncture |
24,150 |
20,656 |
$51K |
| 80061 |
Lipid panel |
3,834 |
3,587 |
$44K |
| 0240U |
|
293 |
242 |
$33K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
288 |
246 |
$31K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,823 |
1,520 |
$23K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
784 |
711 |
$21K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
49 |
48 |
$15K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
781 |
723 |
$11K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
259 |
232 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,367 |
1,272 |
$11K |
| 71045 |
Radiologic examination, chest; single view |
183 |
169 |
$10K |
| 84439 |
|
1,015 |
931 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
882 |
748 |
$8K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
398 |
352 |
$8K |
| 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 |
330 |
307 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
375 |
348 |
$7K |
| 81001 |
|
2,744 |
2,458 |
$6K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
58 |
14 |
$6K |
| 87400 |
|
514 |
376 |
$5K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
85 |
73 |
$5K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
92 |
89 |
$4K |
| 87428 |
|
190 |
180 |
$4K |
| 93041 |
|
76 |
70 |
$3K |
| 87430 |
|
248 |
215 |
$3K |
| 0011A |
|
175 |
158 |
$3K |
| 0012A |
|
89 |
87 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
50 |
47 |
$3K |
| 87070 |
|
284 |
271 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
125 |
110 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
78 |
73 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
181 |
171 |
$2K |
| 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 |
23 |
23 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
51 |
46 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
51 |
46 |
$2K |
| 83735 |
|
333 |
275 |
$2K |
| 81025 |
|
174 |
165 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
222 |
197 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
104 |
98 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
362 |
321 |
$1K |
| 83880 |
|
42 |
41 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
625 |
562 |
$957.13 |
| 80074 |
|
17 |
16 |
$666.82 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
28 |
26 |
$601.76 |
| 84484 |
|
63 |
63 |
$511.27 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
20 |
20 |
$481.60 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17 |
14 |
$376.90 |
| A9270 |
Non-covered item or service |
12,852 |
7,299 |
$304.66 |
| J2704 |
Injection, propofol, 10 mg |
693 |
586 |
$270.37 |
| 82607 |
|
13 |
13 |
$196.04 |
| 82746 |
|
13 |
13 |
$191.10 |
| 84481 |
|
13 |
13 |
$174.59 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
18 |
14 |
$132.66 |
| 87807 |
|
13 |
12 |
$131.00 |
| J3490 |
Unclassified drugs |
974 |
467 |
$101.15 |
| 86592 |
|
20 |
20 |
$85.40 |
| 87077 |
|
52 |
51 |
$77.87 |
| 83690 |
|
14 |
13 |
$68.90 |
| 87186 |
|
12 |
12 |
$64.02 |
| 87210 |
|
24 |
24 |
$63.91 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
19 |
13 |
$62.80 |
| 82570 |
|
12 |
12 |
$62.16 |
| 82043 |
|
12 |
12 |
$52.02 |
| 82044 |
|
12 |
12 |
$49.68 |
| C9399 |
Unclassified drugs or biologicals |
25 |
24 |
$0.90 |
| 91301 |
|
189 |
169 |
$0.02 |
| Q0243 |
Injection, casirivimab and imdevimab, 2400 mg |
54 |
14 |
$0.00 |