| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0360 |
|
75 |
66 |
$86K |
| 0450 |
Emergency room services |
1,175 |
1,133 |
$42K |
| 0510 |
|
284 |
276 |
$19K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
260 |
241 |
$14K |
| 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 |
341 |
338 |
$14K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
24 |
24 |
$12K |
| 0710 |
|
16 |
16 |
$8K |
| 0270 |
|
662 |
443 |
$7K |
| 70450 |
Computed tomography, head or brain; without contrast material |
19 |
19 |
$4K |
| 76770 |
|
52 |
50 |
$4K |
| 99199 |
Unlisted special service, procedure or report |
32 |
28 |
$3K |
| 93975 |
|
31 |
31 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
81 |
81 |
$2K |
| 80053 |
Comprehensive metabolic panel |
257 |
245 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
78 |
74 |
$2K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
50 |
50 |
$2K |
| 0760 |
|
587 |
554 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
232 |
221 |
$2K |
| 95819 |
|
17 |
16 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
27 |
26 |
$1K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
58 |
57 |
$1K |
| 73070 |
|
24 |
23 |
$1K |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
174 |
168 |
$1K |
| 87088 |
|
215 |
210 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
49 |
49 |
$1K |
| 81001 |
|
329 |
319 |
$1K |
| J3490 |
Unclassified drugs |
92 |
63 |
$952.61 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
99 |
94 |
$914.06 |
| 87505 |
|
18 |
18 |
$804.70 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
84 |
73 |
$793.87 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
26 |
25 |
$728.87 |
| 0700 |
|
15 |
15 |
$654.64 |
| 73590 |
|
25 |
23 |
$638.45 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
28 |
28 |
$637.32 |
| 86140 |
|
128 |
120 |
$606.86 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
23 |
23 |
$576.26 |
| 82728 |
|
20 |
19 |
$524.61 |
| 73630 |
|
31 |
29 |
$516.50 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
24 |
23 |
$512.56 |
| 97802 |
|
16 |
16 |
$511.69 |
| 84439 |
|
37 |
37 |
$493.16 |
| 85007 |
|
56 |
51 |
$492.86 |
| 73610 |
|
17 |
17 |
$452.23 |
| 74019 |
|
22 |
22 |
$448.16 |
| Q3014 |
Telehealth originating site facility fee |
12 |
12 |
$442.32 |
| 94664 |
|
15 |
14 |
$421.57 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
22 |
22 |
$413.68 |
| 72170 |
|
20 |
20 |
$375.61 |
| 73090 |
|
38 |
34 |
$373.83 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
13 |
12 |
$355.63 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
110 |
102 |
$351.16 |
| 83690 |
|
67 |
66 |
$348.83 |
| 85397 |
|
12 |
12 |
$337.83 |
| 93325 |
|
42 |
37 |
$315.51 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
40 |
32 |
$296.01 |
| 85246 |
|
12 |
12 |
$295.38 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
32 |
32 |
$287.36 |
| 77077 |
|
15 |
14 |
$285.74 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63 |
56 |
$282.50 |
| 70360 |
|
18 |
17 |
$272.33 |
| 84484 |
|
16 |
15 |
$272.15 |
| 86003 |
|
33 |
17 |
$261.22 |
| 73140 |
|
18 |
14 |
$257.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
48 |
48 |
$255.90 |
| 85240 |
|
14 |
13 |
$249.69 |
| 74018 |
|
40 |
39 |
$246.71 |
| 76870 |
|
12 |
12 |
$239.76 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
61 |
58 |
$231.96 |
| 87040 |
|
27 |
26 |
$217.82 |
| 85045 |
|
17 |
15 |
$217.14 |
| 86160 |
|
27 |
13 |
$211.90 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
17 |
$208.38 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
31 |
30 |
$206.78 |
| 73110 |
|
15 |
14 |
$206.37 |
| 94010 |
|
13 |
13 |
$200.41 |
| 71045 |
Radiologic examination, chest; single view |
12 |
12 |
$187.19 |
| 82784 |
|
16 |
15 |
$184.43 |
| 80069 |
|
24 |
24 |
$176.07 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
61 |
55 |
$174.48 |
| 85730 |
|
22 |
22 |
$171.81 |
| 85651 |
|
49 |
49 |
$170.79 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
57 |
54 |
$157.30 |
| 87186 |
|
35 |
35 |
$148.73 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
96 |
92 |
$137.79 |
| 73100 |
|
16 |
14 |
$136.53 |
| 87081 |
|
43 |
43 |
$135.00 |
| 73000 |
|
14 |
14 |
$134.15 |
| 85610 |
|
29 |
29 |
$130.38 |
| 86635 |
|
14 |
13 |
$125.89 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
15 |
14 |
$124.09 |
| 84703 |
|
73 |
72 |
$120.46 |
| J2704 |
Injection, propofol, 10 mg |
40 |
40 |
$117.28 |
| 82570 |
|
30 |
27 |
$103.68 |
| 87077 |
|
36 |
36 |
$96.95 |
| 82947 |
|
16 |
16 |
$88.69 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
13 |
$62.50 |
| 83615 |
|
13 |
13 |
$61.85 |
| 84156 |
|
25 |
24 |
$60.05 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
20 |
20 |
$53.54 |
| 80061 |
Lipid panel |
17 |
17 |
$53.18 |
| 93321 |
|
19 |
17 |
$49.61 |
| 86038 |
|
15 |
15 |
$48.85 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13 |
13 |
$45.14 |
| 84550 |
|
13 |
13 |
$43.79 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
18 |
18 |
$40.55 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
26 |
26 |
$39.30 |
| 83516 |
|
17 |
12 |
$36.33 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
20 |
20 |
$35.72 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
18 |
18 |
$31.50 |
| 88304 |
|
14 |
13 |
$29.79 |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
169 |
126 |
$13.15 |
| 99215 |
Prolong outpt/office vis |
17 |
17 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
16 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |
| 93304 |
|
24 |
22 |
$0.00 |