| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2022 |
Case management, per month |
428 |
413 |
$129K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,192 |
4,192 |
$55K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
630 |
357 |
$52K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,535 |
2,689 |
$36K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,774 |
2,113 |
$23K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,571 |
1,176 |
$16K |
| 70450 |
Computed tomography, head or brain; without contrast material |
821 |
523 |
$14K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
11,126 |
8,594 |
$14K |
| 71046 |
Radiologic examination, chest; 2 views |
1,586 |
1,133 |
$13K |
| 80053 |
Comprehensive metabolic panel |
8,374 |
6,513 |
$13K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
861 |
534 |
$12K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,678 |
1,308 |
$12K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,772 |
1,495 |
$8K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
542 |
481 |
$8K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,208 |
1,346 |
$7K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,470 |
2,055 |
$6K |
| 73630 |
|
1,008 |
617 |
$6K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
12 |
12 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,039 |
2,482 |
$6K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,528 |
1,941 |
$6K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,066 |
2,446 |
$6K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,002 |
2,123 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
13,828 |
10,747 |
$6K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,611 |
1,773 |
$5K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,431 |
1,672 |
$5K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,039 |
2,021 |
$5K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
411 |
295 |
$4K |
| 86140 |
|
2,721 |
2,271 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
2,065 |
1,508 |
$4K |
| 80076 |
|
1,666 |
1,421 |
$4K |
| 87631 |
|
205 |
185 |
$3K |
| 83690 |
|
2,369 |
1,944 |
$3K |
| 80306 |
|
1,425 |
1,218 |
$3K |
| 81001 |
|
3,971 |
3,246 |
$3K |
| 84145 |
|
608 |
520 |
$3K |
| 84439 |
|
2,832 |
2,564 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,860 |
2,061 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,934 |
1,536 |
$2K |
| 82728 |
|
1,137 |
1,001 |
$2K |
| A0425 |
Ground mileage, per statute mile |
588 |
335 |
$2K |
| 83615 |
|
1,685 |
1,413 |
$2K |
| 82150 |
|
1,682 |
1,438 |
$2K |
| 80050 |
General health panel |
562 |
510 |
$2K |
| 85652 |
|
1,653 |
1,430 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,782 |
2,551 |
$2K |
| 85027 |
|
860 |
740 |
$1K |
| 82977 |
|
1,497 |
1,290 |
$1K |
| 80061 |
Lipid panel |
1,818 |
1,706 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
1,279 |
721 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
390 |
355 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
404 |
367 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
880 |
816 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
107 |
105 |
$981.97 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,128 |
827 |
$893.49 |
| 73610 |
|
78 |
53 |
$891.90 |
| J3490 |
Unclassified drugs |
129 |
86 |
$884.55 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
226 |
150 |
$783.76 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,511 |
2,329 |
$782.79 |
| 87081 |
|
196 |
172 |
$759.57 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
188 |
163 |
$692.49 |
| 85007 |
|
562 |
473 |
$689.55 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
392 |
282 |
$672.36 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
249 |
107 |
$625.00 |
| 87186 |
|
388 |
316 |
$574.20 |
| 84484 |
|
1,880 |
1,412 |
$504.88 |
| 87077 |
|
421 |
331 |
$391.50 |
| 84702 |
|
129 |
96 |
$332.09 |
| 83605 |
|
545 |
412 |
$331.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,358 |
1,069 |
$322.55 |
| 81003 |
|
808 |
639 |
$321.25 |
| 83735 |
|
1,097 |
821 |
$319.49 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
116 |
106 |
$273.59 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
265 |
244 |
$270.90 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
113 |
78 |
$264.05 |
| 82077 |
|
227 |
175 |
$261.66 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
177 |
140 |
$259.21 |
| 81025 |
|
280 |
235 |
$257.52 |
| 87040 |
|
198 |
121 |
$220.48 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
16 |
15 |
$208.80 |
| 73562 |
|
22 |
12 |
$198.00 |
| 86900 |
|
214 |
180 |
$198.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
180 |
100 |
$194.92 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,319 |
1,026 |
$172.80 |
| 83880 |
|
1,187 |
948 |
$161.99 |
| 86803 |
|
352 |
320 |
$156.60 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
62 |
49 |
$131.40 |
| 83550 |
|
138 |
121 |
$120.60 |
| 86901 |
|
213 |
180 |
$120.60 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
255 |
202 |
$115.38 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
358 |
267 |
$112.58 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
19 |
12 |
$108.90 |
| 83540 |
|
154 |
134 |
$96.30 |
| 87070 |
|
32 |
26 |
$90.00 |
| 86850 |
|
226 |
190 |
$85.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
59 |
52 |
$67.50 |
| 85610 |
|
377 |
275 |
$32.39 |
| 82947 |
|
240 |
157 |
$10.87 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
144 |
126 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
282 |
141 |
$0.00 |
| 82607 |
|
306 |
279 |
$0.00 |
| 36591 |
|
151 |
75 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
127 |
77 |
$0.00 |
| 82950 |
|
54 |
54 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
48 |
38 |
$0.00 |
| 85379 |
|
91 |
74 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
91 |
65 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
39 |
37 |
$0.00 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
42 |
24 |
$0.00 |
| 86780 |
|
88 |
84 |
$0.00 |
| 87340 |
|
130 |
116 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
60 |
57 |
$0.00 |
| 82550 |
|
37 |
36 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
13 |
12 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
32 |
24 |
$0.00 |
| 0240U |
|
17 |
13 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
29 |
14 |
$0.00 |
| 86592 |
|
13 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
395 |
253 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
48 |
38 |
$0.00 |
| J0134 |
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg |
119 |
92 |
$0.00 |
| J1596 |
Injection, glycopyrrolate, 0.1 mg |
29 |
25 |
$0.00 |
| 82570 |
|
27 |
25 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
17 |
12 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
90 |
64 |
$0.00 |
| 87210 |
|
14 |
12 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
13 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
24 |
15 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
17 |
15 |
$0.00 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
60 |
29 |
$0.00 |
| 99490 |
Ccm add 20min |
25 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
14 |
$0.00 |
| 71250 |
|
56 |
36 |
$0.00 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
20 |
15 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
13 |
$0.00 |
| C9113 |
Injection, pantoprazole sodium, per vial |
29 |
24 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
20 |
15 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
12 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
15 |
13 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
24 |
15 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
28 |
13 |
$0.00 |
| 82565 |
|
27 |
26 |
$0.00 |