| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12,061 |
10,990 |
$629K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,460 |
4,865 |
$586K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
253 |
237 |
$219K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,379 |
1,219 |
$214K |
| 70450 |
Computed tomography, head or brain; without contrast material |
529 |
489 |
$164K |
| 71046 |
Radiologic examination, chest; 2 views |
1,663 |
1,510 |
$118K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,027 |
820 |
$110K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,093 |
917 |
$95K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,512 |
1,232 |
$89K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
692 |
583 |
$65K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,159 |
1,046 |
$59K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,101 |
751 |
$57K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,544 |
1,312 |
$51K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,147 |
1,091 |
$35K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
44 |
42 |
$33K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,186 |
333 |
$27K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,895 |
3,335 |
$27K |
| 80053 |
Comprehensive metabolic panel |
2,697 |
2,397 |
$27K |
| 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 |
238 |
218 |
$20K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
736 |
686 |
$18K |
| J3490 |
Unclassified drugs |
1,330 |
986 |
$13K |
| 93041 |
|
342 |
313 |
$11K |
| 94760 |
|
763 |
532 |
$10K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,159 |
971 |
$10K |
| 81025 |
|
1,411 |
1,231 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
5,411 |
4,383 |
$10K |
| 73564 |
|
139 |
126 |
$9K |
| 80061 |
Lipid panel |
652 |
609 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
702 |
685 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
585 |
547 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
171 |
153 |
$8K |
| 80069 |
|
1,501 |
1,160 |
$8K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,124 |
616 |
$7K |
| 73630 |
|
102 |
97 |
$7K |
| 84443 |
Thyroid stimulating hormone (TSH) |
462 |
430 |
$7K |
| 81001 |
|
2,070 |
1,834 |
$6K |
| 94664 |
|
155 |
143 |
$6K |
| 87070 |
|
601 |
579 |
$5K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,202 |
1,081 |
$5K |
| 84484 |
|
969 |
767 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
115 |
106 |
$5K |
| 80305 |
|
259 |
240 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
460 |
433 |
$5K |
| G0378 |
Hospital observation service, per hour |
65 |
24 |
$4K |
| A9270 |
Non-covered item or service |
24,510 |
14,397 |
$4K |
| 73610 |
|
58 |
51 |
$4K |
| 85027 |
|
884 |
754 |
$4K |
| 73130 |
|
40 |
39 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
568 |
510 |
$4K |
| 97010 |
|
253 |
68 |
$4K |
| 96376 |
|
34 |
26 |
$4K |
| 72100 |
|
41 |
40 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
694 |
613 |
$3K |
| 0012A |
|
56 |
54 |
$3K |
| 83605 |
|
505 |
403 |
$3K |
| 0011A |
|
85 |
77 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
484 |
445 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
112 |
103 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
112 |
103 |
$3K |
| 83690 |
|
552 |
503 |
$3K |
| 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 |
86 |
83 |
$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 |
55 |
51 |
$3K |
| 83880 |
|
157 |
144 |
$3K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
28 |
26 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
310 |
263 |
$2K |
| 94761 |
|
192 |
171 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
26 |
26 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
362 |
345 |
$2K |
| 81003 |
|
856 |
795 |
$2K |
| 82948 |
|
578 |
365 |
$2K |
| 87040 |
|
210 |
144 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
29 |
26 |
$2K |
| 97162 |
|
15 |
13 |
$1K |
| 73030 |
|
17 |
12 |
$958.17 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
268 |
203 |
$957.61 |
| 73140 |
|
14 |
14 |
$953.33 |
| 73110 |
|
12 |
12 |
$942.34 |
| 29125 |
|
13 |
12 |
$739.53 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
427 |
317 |
$687.86 |
| 87077 |
|
84 |
73 |
$580.06 |
| 87186 |
|
77 |
67 |
$521.61 |
| 87210 |
|
88 |
77 |
$306.20 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
16 |
14 |
$258.18 |
| 83735 |
|
51 |
42 |
$252.86 |
| 87807 |
|
15 |
15 |
$214.20 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
42 |
28 |
$140.31 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
24 |
24 |
$127.72 |
| 85610 |
|
41 |
32 |
$113.46 |
| 91301 |
|
147 |
125 |
$0.40 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
49 |
37 |
$0.00 |
| E0110 |
Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips |
13 |
12 |
$0.00 |