| Code | Description | Claims | Beneficiaries | Total Paid |
| 0111 |
|
307 |
289 |
$3.40M |
| 0450 |
Emergency room services |
32,960 |
28,794 |
$1.32M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
12,726 |
10,490 |
$390K |
| 74174 |
|
1,641 |
1,510 |
$356K |
| 99205 |
Prolong outpt/office vis |
2,289 |
1,973 |
$303K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,916 |
2,684 |
$260K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,298 |
8,734 |
$188K |
| 0200 |
|
15 |
13 |
$187K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
10,032 |
8,408 |
$185K |
| G0378 |
Hospital observation service, per hour |
809 |
458 |
$164K |
| 99215 |
Prolong outpt/office vis |
1,185 |
957 |
$161K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
965 |
904 |
$125K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,495 |
6,264 |
$110K |
| 0510 |
|
4,486 |
3,798 |
$101K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
589 |
562 |
$93K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,051 |
1,929 |
$75K |
| 0250 |
|
23,330 |
18,234 |
$69K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
11,907 |
10,189 |
$66K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13,285 |
11,408 |
$65K |
| 99199 |
Unlisted special service, procedure or report |
877 |
829 |
$60K |
| 71046 |
Radiologic examination, chest; 2 views |
3,534 |
3,191 |
$48K |
| 70486 |
|
377 |
349 |
$42K |
| 71045 |
Radiologic examination, chest; single view |
5,926 |
5,430 |
$42K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,419 |
5,344 |
$39K |
| 80076 |
|
7,581 |
6,648 |
$38K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,386 |
2,863 |
$36K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,585 |
1,442 |
$34K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,513 |
1,376 |
$33K |
| 84484 |
|
4,177 |
3,489 |
$30K |
| 99221 |
|
3,299 |
2,719 |
$28K |
| J1953 |
Injection, levetiracetam, 10 mg |
120 |
104 |
$27K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,886 |
1,765 |
$27K |
| 83690 |
|
5,285 |
4,639 |
$22K |
| 80053 |
Comprehensive metabolic panel |
2,580 |
2,330 |
$19K |
| 83605 |
|
2,515 |
2,097 |
$19K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
319 |
286 |
$18K |
| 83880 |
|
1,043 |
889 |
$17K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
435 |
390 |
$17K |
| 73564 |
|
762 |
690 |
$17K |
| 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 |
292 |
286 |
$15K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
305 |
274 |
$15K |
| 73610 |
|
785 |
710 |
$15K |
| 85610 |
|
5,763 |
5,133 |
$15K |
| 93971 |
|
213 |
179 |
$14K |
| 73110 |
|
658 |
597 |
$12K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,102 |
1,876 |
$11K |
| 73030 |
|
569 |
526 |
$11K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
500 |
440 |
$11K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
459 |
338 |
$11K |
| 86703 |
|
1,373 |
1,267 |
$11K |
| 80047 |
|
2,028 |
1,808 |
$11K |
| 73080 |
|
475 |
426 |
$10K |
| 73590 |
|
608 |
559 |
$10K |
| 87040 |
|
805 |
701 |
$9K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
931 |
820 |
$9K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
510 |
445 |
$9K |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
1,777 |
1,523 |
$9K |
| 73090 |
|
552 |
487 |
$9K |
| 86850 |
|
2,429 |
2,183 |
$9K |
| 80306 |
|
360 |
338 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
253 |
229 |
$8K |
| 87522 |
Neg quan hep c or qual rna |
345 |
319 |
$8K |
| 76801 |
|
184 |
151 |
$8K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
220 |
217 |
$8K |
| 82550 |
|
1,548 |
1,274 |
$8K |
| 87088 |
|
1,963 |
1,734 |
$7K |
| 73130 |
|
411 |
372 |
$7K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
178 |
174 |
$7K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
671 |
610 |
$7K |
| 99217 |
|
47 |
46 |
$7K |
| 86901 |
|
2,602 |
2,260 |
$6K |
| 73630 |
|
378 |
353 |
$6K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
275 |
268 |
$6K |
| 81000 |
|
3,191 |
2,806 |
$6K |
| 0255 |
|
107 |
106 |
$6K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
358 |
321 |
$6K |
| 81025 |
|
2,033 |
1,742 |
$6K |
| 81001 |
|
3,072 |
2,677 |
$6K |
| 0761 |
|
470 |
390 |
$5K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
363 |
328 |
$5K |
| 0516 |
|
188 |
170 |
$5K |
| 73120 |
|
410 |
380 |
$5K |
| 86900 |
|
2,591 |
2,250 |
$5K |
| 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 |
516 |
507 |
$5K |
| 73620 |
|
395 |
355 |
$5K |
| 99218 |
|
84 |
82 |
$5K |
| 86141 |
|
771 |
671 |
$5K |
| 85730 |
|
1,271 |
1,162 |
$5K |
| 84703 |
|
1,043 |
900 |
$5K |
| 94760 |
|
615 |
548 |
$5K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
412 |
380 |
$5K |
| J1630 |
Injection, haloperidol, up to 5 mg |
1,027 |
888 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
30 |
26 |
$4K |
| 0760 |
|
289 |
224 |
$4K |
| J2060 |
Injection, lorazepam, 2 mg |
882 |
741 |
$4K |
| 70498 |
|
25 |
25 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
636 |
562 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
602 |
573 |
$3K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
597 |
520 |
$3K |
| 85027 |
|
808 |
726 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
10,419 |
8,814 |
$3K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
540 |
417 |
$3K |
| 80061 |
Lipid panel |
357 |
339 |
$3K |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
137 |
94 |
$3K |
| 80305 |
|
489 |
399 |
$3K |
| 72100 |
|
142 |
127 |
$3K |
| 81015 |
|
1,445 |
1,374 |
$3K |
| 87070 |
|
485 |
406 |
$3K |
| J8540 |
Dexamethasone, oral, 0.25 mg |
216 |
161 |
$3K |
| 87210 |
|
869 |
780 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
104 |
101 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
583 |
478 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
595 |
548 |
$2K |
| 73060 |
|
146 |
129 |
$2K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
628 |
549 |
$2K |
| 72170 |
|
153 |
134 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
76 |
72 |
$2K |
| 87536 |
|
62 |
59 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
137 |
130 |
$2K |
| 87186 |
|
396 |
346 |
$2K |
| 82962 |
|
1,279 |
1,094 |
$2K |
| 93041 |
|
273 |
182 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
197 |
168 |
$2K |
| 73502 |
|
84 |
71 |
$2K |
| 97161 |
|
73 |
72 |
$2K |
| 81002 |
|
1,286 |
1,093 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
29 |
29 |
$2K |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
704 |
531 |
$2K |
| 73552 |
|
96 |
90 |
$2K |
| 83026 |
|
872 |
789 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
731 |
564 |
$1K |
| 83735 |
|
303 |
230 |
$1K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
62 |
59 |
$1K |
| 82140 |
|
184 |
167 |
$1K |
| 86592 |
|
502 |
471 |
$1K |
| 73562 |
|
53 |
50 |
$1K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
359 |
316 |
$1K |
| Q0163 |
Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen |
687 |
595 |
$1K |
| 76870 |
|
33 |
28 |
$1K |
| 84439 |
|
212 |
198 |
$1K |
| 88182 |
|
39 |
37 |
$1K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
236 |
195 |
$941.66 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
155 |
142 |
$895.33 |
| 84100 |
|
282 |
217 |
$889.17 |
| 87340 |
|
179 |
164 |
$881.94 |
| J1940 |
Injection, furosemide, up to 20 mg |
117 |
87 |
$832.55 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
14 |
14 |
$758.69 |
| 59025 |
Fetal non-stress test |
16 |
13 |
$755.70 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
72 |
53 |
$737.45 |
| 99222 |
Initial hospital care, per day, moderate complexity |
13 |
12 |
$724.70 |
| 85378 |
|
155 |
137 |
$724.50 |
| J7510 |
Prednisolone oral, per 5 mg |
168 |
152 |
$715.30 |
| 86593 |
|
314 |
296 |
$706.92 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13 |
13 |
$681.40 |
| 86480 |
|
25 |
24 |
$665.93 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
158 |
149 |
$661.75 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
97 |
82 |
$656.94 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
87 |
85 |
$648.07 |
| 76770 |
|
14 |
13 |
$595.74 |
| 84702 |
|
56 |
54 |
$562.44 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
477 |
421 |
$547.90 |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
14 |
14 |
$488.97 |
| 85007 |
|
264 |
217 |
$436.44 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
102 |
77 |
$414.26 |
| 80185 |
|
86 |
57 |
$398.73 |
| 88142 |
|
100 |
96 |
$377.89 |
| 84145 |
|
26 |
26 |
$361.79 |
| 0320 |
|
126 |
103 |
$357.57 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
124 |
121 |
$341.33 |
| 82274 |
|
28 |
26 |
$335.51 |
| 93000 |
|
13 |
13 |
$321.67 |
| 87205 |
|
115 |
84 |
$277.57 |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
92 |
63 |
$232.25 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
654 |
496 |
$231.30 |
| S0028 |
Injection, famotidine, 20 mg |
264 |
215 |
$214.80 |
| 73501 |
|
14 |
14 |
$200.74 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
18 |
16 |
$171.16 |
| 80320 |
|
493 |
432 |
$170.54 |
| 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 |
42 |
41 |
$163.96 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$161.00 |
| 85652 |
|
85 |
81 |
$155.32 |
| 98960 |
|
89 |
63 |
$152.20 |
| 74018 |
|
13 |
12 |
$149.73 |
| 73140 |
|
13 |
13 |
$143.35 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
31 |
25 |
$139.38 |
| 0300 |
|
28 |
14 |
$114.17 |
| 88187 |
|
16 |
12 |
$111.96 |
| 81003 |
|
103 |
102 |
$92.48 |
| 82043 |
|
16 |
16 |
$89.21 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
15 |
12 |
$66.35 |
| 86780 |
|
13 |
12 |
$66.12 |
| 82540 |
|
16 |
16 |
$62.75 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$53.06 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
53 |
25 |
$51.03 |
| 80329 |
|
517 |
427 |
$49.98 |
| S5550 |
Insulin, rapid onset, 5 units |
59 |
39 |
$48.22 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
16 |
12 |
$23.62 |
| 96415 |
|
15 |
12 |
$22.88 |
| 89050 |
|
23 |
13 |
$18.88 |
| 85008 |
|
15 |
15 |
$9.03 |
| 92557 |
|
25 |
24 |
$1.98 |
| 91300 |
|
12 |
12 |
$0.00 |