| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
6,636 |
6,177 |
$320K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,098 |
3,365 |
$122K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,126 |
1,029 |
$54K |
| 85027 |
|
8,824 |
6,775 |
$48K |
| 80053 |
Comprehensive metabolic panel |
4,057 |
3,528 |
$31K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
703 |
653 |
$22K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
397 |
101 |
$19K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
295 |
81 |
$17K |
| 59025 |
Fetal non-stress test |
379 |
195 |
$11K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
262 |
247 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
693 |
348 |
$9K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
273 |
244 |
$7K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
288 |
261 |
$6K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
577 |
485 |
$6K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
202 |
50 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
132 |
123 |
$5K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
131 |
121 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
106 |
97 |
$4K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
149 |
117 |
$4K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
486 |
425 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,040 |
901 |
$3K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
82 |
26 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
185 |
161 |
$3K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
59 |
54 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
388 |
346 |
$3K |
| 85007 |
|
2,426 |
1,474 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
121 |
116 |
$3K |
| 83655 |
|
173 |
165 |
$3K |
| 81001 |
|
749 |
625 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
217 |
208 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
31 |
30 |
$2K |
| 86592 |
|
361 |
342 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
15 |
14 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
13 |
12 |
$1K |
| G0378 |
Hospital observation service, per hour |
14 |
13 |
$1K |
| 86885 |
|
162 |
150 |
$1K |
| 80061 |
Lipid panel |
142 |
140 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
229 |
224 |
$1K |
| 83690 |
|
164 |
153 |
$968.08 |
| 70450 |
Computed tomography, head or brain; without contrast material |
15 |
15 |
$965.42 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
73 |
72 |
$951.68 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
25 |
25 |
$937.29 |
| 84484 |
|
113 |
91 |
$923.17 |
| 87186 |
|
109 |
99 |
$919.74 |
| 71046 |
Radiologic examination, chest; 2 views |
102 |
100 |
$871.92 |
| 87077 |
|
113 |
102 |
$759.55 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
13 |
12 |
$736.19 |
| 82728 |
|
50 |
50 |
$721.07 |
| 86901 |
|
162 |
150 |
$695.53 |
| 88142 |
|
38 |
38 |
$674.98 |
| 36415 |
Collection of venous blood by venipuncture |
3,402 |
2,300 |
$608.10 |
| 86900 |
|
161 |
150 |
$571.88 |
| 81025 |
|
54 |
53 |
$467.63 |
| 82552 |
|
45 |
32 |
$452.80 |
| 83874 |
|
44 |
32 |
$431.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
79 |
49 |
$430.95 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12 |
12 |
$400.85 |
| 87070 |
|
53 |
50 |
$291.20 |
| 84702 |
|
32 |
25 |
$288.40 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15 |
13 |
$284.90 |
| 85610 |
|
90 |
82 |
$273.45 |
| 84439 |
|
19 |
19 |
$273.06 |
| Q3014 |
Telehealth originating site facility fee |
24 |
18 |
$237.11 |
| 83735 |
|
48 |
41 |
$235.99 |
| 87420 |
|
17 |
17 |
$222.36 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
25 |
12 |
$198.24 |
| 85730 |
|
49 |
48 |
$194.24 |
| 87340 |
|
12 |
12 |
$176.33 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
131 |
81 |
$172.22 |
| 82247 |
|
18 |
15 |
$131.24 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
53 |
52 |
$119.46 |
| 83880 |
|
15 |
15 |
$116.24 |
| 86762 |
|
12 |
12 |
$108.93 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
48 |
42 |
$98.83 |
| 80076 |
|
28 |
27 |
$97.90 |
| A0425 |
Ground mileage, per statute mile |
76 |
64 |
$91.17 |
| 83605 |
|
14 |
12 |
$89.10 |
| 85379 |
|
53 |
50 |
$83.78 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
102 |
82 |
$80.43 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
57 |
50 |
$67.22 |
| 86140 |
|
59 |
50 |
$59.95 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
31 |
24 |
$57.92 |
| 85018 |
|
29 |
29 |
$49.99 |
| 82550 |
|
36 |
36 |
$37.08 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
13 |
12 |
$35.85 |
| 85384 |
|
36 |
36 |
$30.38 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
198 |
140 |
$28.57 |
| 85014 |
|
16 |
16 |
$27.36 |
| 83615 |
|
36 |
36 |
$23.48 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
29 |
14 |
$12.53 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
46 |
43 |
$11.90 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
81 |
75 |
$9.91 |
| A9270 |
Non-covered item or service |
41 |
31 |
$6.63 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
101 |
37 |
$0.52 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
13 |
$0.00 |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
17 |
12 |
$0.00 |
| C1752 |
Catheter, hemodialysis/peritoneal, short-term |
20 |
17 |
$0.00 |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
16 |
15 |
$0.00 |