| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12,296 |
11,435 |
$1.84M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,365 |
8,938 |
$987K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
6,348 |
3,668 |
$474K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
4,713 |
2,910 |
$374K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,165 |
2,894 |
$225K |
| A0425 |
Ground mileage, per statute mile |
13,530 |
7,836 |
$146K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
824 |
707 |
$115K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
1,819 |
1,192 |
$73K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,480 |
1,215 |
$41K |
| 87631 |
|
949 |
807 |
$34K |
| 71045 |
Radiologic examination, chest; single view |
1,018 |
889 |
$23K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
600 |
515 |
$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 |
142 |
124 |
$9K |
| 80053 |
Comprehensive metabolic panel |
12,345 |
11,024 |
$6K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
578 |
577 |
$6K |
| 87081 |
|
953 |
921 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
110 |
110 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
16,665 |
15,037 |
$3K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
61 |
51 |
$3K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
32 |
30 |
$2K |
| 86900 |
|
39 |
39 |
$2K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
39 |
13 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,530 |
1,099 |
$1K |
| 87150 |
|
30 |
30 |
$1K |
| 87088 |
|
295 |
285 |
$1K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,919 |
1,173 |
$975.03 |
| 85027 |
|
1,119 |
770 |
$925.02 |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$912.76 |
| 84443 |
Thyroid stimulating hormone (TSH) |
76 |
73 |
$825.67 |
| 86780 |
|
53 |
52 |
$811.50 |
| 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 |
51 |
39 |
$800.00 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
14 |
14 |
$734.17 |
| 86762 |
|
38 |
38 |
$651.60 |
| 86703 |
|
51 |
51 |
$619.36 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,446 |
1,195 |
$579.97 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,255 |
868 |
$573.80 |
| 87400 |
|
19 |
19 |
$573.04 |
| 87340 |
|
38 |
38 |
$493.62 |
| 87634 |
|
100 |
97 |
$230.07 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
143 |
143 |
$226.20 |
| 83605 |
|
1,280 |
1,079 |
$123.34 |
| J3490 |
Unclassified drugs |
1,128 |
725 |
$98.71 |
| 82803 |
|
1,065 |
913 |
$76.89 |
| 81001 |
|
613 |
542 |
$43.74 |
| 83735 |
|
742 |
648 |
$34.38 |
| 80069 |
|
16 |
12 |
$31.95 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
36 |
36 |
$27.84 |
| 83690 |
|
459 |
413 |
$21.88 |
| 84484 |
|
174 |
143 |
$19.82 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,356 |
1,209 |
$15.66 |
| 84703 |
|
287 |
273 |
$12.64 |
| 86140 |
|
93 |
79 |
$5.18 |
| 84100 |
|
200 |
182 |
$3.98 |
| 85610 |
|
406 |
350 |
$3.42 |
| 85652 |
|
46 |
40 |
$2.70 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
445 |
401 |
$1.17 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
77 |
74 |
$0.98 |
| J2704 |
Injection, propofol, 10 mg |
51 |
25 |
$0.00 |
| 85730 |
|
15 |
15 |
$0.00 |
| 86901 |
|
39 |
39 |
$0.00 |
| 86850 |
|
39 |
39 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
18 |
14 |
$0.00 |
| 82805 |
|
56 |
54 |
$0.00 |
| 84145 |
|
14 |
13 |
$0.00 |