| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
71,309 |
63,317 |
$3.74M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
107,669 |
93,957 |
$3.55M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
11,017 |
9,575 |
$1.79M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31,027 |
28,310 |
$1.53M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
47,017 |
41,732 |
$1.09M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,603 |
2,497 |
$638K |
| A0425 |
Ground mileage, per statute mile |
13,021 |
11,201 |
$624K |
| 80053 |
Comprehensive metabolic panel |
28,824 |
26,590 |
$440K |
| 70450 |
Computed tomography, head or brain; without contrast material |
3,043 |
2,934 |
$358K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,576 |
5,005 |
$347K |
| 59425 |
|
4,489 |
2,989 |
$326K |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,101 |
4,508 |
$323K |
| J3490 |
Unclassified drugs |
15,064 |
9,951 |
$306K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,814 |
3,714 |
$267K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,643 |
2,636 |
$265K |
| Z7502 |
|
7,521 |
7,345 |
$264K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,898 |
8,837 |
$262K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,872 |
1,814 |
$260K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
5,653 |
1,661 |
$253K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27,739 |
25,539 |
$247K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
8,702 |
7,618 |
$241K |
| Q3014 |
Telehealth originating site facility fee |
7,869 |
6,938 |
$213K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,904 |
3,491 |
$176K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,231 |
3,228 |
$175K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,526 |
2,521 |
$172K |
| 97139 |
|
8,387 |
1,474 |
$170K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,583 |
2,684 |
$169K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,323 |
11,211 |
$160K |
| 71046 |
Radiologic examination, chest; 2 views |
6,366 |
6,142 |
$150K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,140 |
3,127 |
$145K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
6,813 |
6,434 |
$145K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,567 |
6,491 |
$139K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,966 |
1,956 |
$136K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
2,112 |
2,070 |
$134K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
4,182 |
4,147 |
$131K |
| 92552 |
|
6,205 |
6,198 |
$123K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,572 |
1,523 |
$120K |
| 80061 |
Lipid panel |
7,209 |
7,145 |
$109K |
| 76830 |
Ultrasound, transvaginal |
1,715 |
1,685 |
$106K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,346 |
1,165 |
$104K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,507 |
1,388 |
$103K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
3,636 |
3,280 |
$101K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
1,240 |
759 |
$100K |
| 90715 |
|
3,369 |
3,355 |
$99K |
| 0270 |
|
11,239 |
7,139 |
$98K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,183 |
7,102 |
$92K |
| 76801 |
|
1,376 |
1,278 |
$90K |
| 71045 |
Radiologic examination, chest; single view |
6,254 |
5,967 |
$84K |
| 0360 |
|
583 |
579 |
$80K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,875 |
1,875 |
$73K |
| 99215 |
Prolong outpt/office vis |
900 |
862 |
$73K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
8,835 |
8,357 |
$72K |
| 87631 |
|
973 |
952 |
$70K |
| 83880 |
|
2,365 |
2,264 |
$66K |
| 81001 |
|
15,579 |
14,613 |
$65K |
| 85730 |
|
9,356 |
8,762 |
$65K |
| 83690 |
|
8,217 |
7,596 |
$62K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
9,881 |
8,670 |
$61K |
| 84484 |
|
4,951 |
4,602 |
$61K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,331 |
2,434 |
$56K |
| 73562 |
|
2,132 |
2,040 |
$56K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,196 |
2,784 |
$55K |
| 81025 |
|
11,002 |
10,556 |
$54K |
| 90686 |
|
2,465 |
2,462 |
$54K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
371 |
342 |
$51K |
| 76641 |
|
717 |
712 |
$50K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
400 |
395 |
$50K |
| 73630 |
|
1,778 |
1,711 |
$47K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
558 |
553 |
$47K |
| 85610 |
|
10,022 |
9,328 |
$46K |
| 82150 |
|
6,380 |
5,976 |
$46K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,098 |
1,093 |
$45K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
629 |
622 |
$44K |
| 80305 |
|
2,878 |
2,724 |
$41K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
985 |
919 |
$41K |
| 73030 |
|
1,517 |
1,469 |
$39K |
| 90656 |
|
2,324 |
2,322 |
$37K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
643 |
633 |
$37K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
7,163 |
6,011 |
$36K |
| 81003 |
|
15,081 |
13,114 |
$36K |
| 73610 |
|
1,173 |
1,146 |
$35K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
543 |
496 |
$32K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,507 |
2,671 |
$30K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,606 |
1,048 |
$30K |
| 83874 |
|
2,590 |
2,468 |
$29K |
| 72110 |
|
717 |
706 |
$29K |
| 87186 |
|
2,826 |
2,737 |
$28K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
3,149 |
2,980 |
$28K |
| 83735 |
|
3,694 |
3,456 |
$27K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
147 |
147 |
$26K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
628 |
618 |
$26K |
| 87077 |
|
3,376 |
3,272 |
$24K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
7,483 |
4,241 |
$24K |
| 97750 |
|
392 |
389 |
$23K |
| 87040 |
|
1,182 |
1,115 |
$22K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,290 |
2,264 |
$22K |
| 0637 |
|
14,545 |
9,404 |
$21K |
| 97802 |
|
968 |
924 |
$21K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
2,578 |
1,868 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,773 |
1,747 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
246 |
245 |
$21K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
454 |
189 |
$20K |
| 99173 |
|
4,977 |
4,972 |
$20K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,693 |
1,667 |
$20K |
| 73130 |
|
713 |
684 |
$20K |
| 82043 |
|
2,258 |
2,234 |
$19K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
115 |
115 |
$18K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,697 |
1,608 |
$18K |
| 83605 |
|
1,334 |
1,265 |
$17K |
| 73110 |
|
561 |
541 |
$17K |
| 72100 |
|
553 |
544 |
$17K |
| 84703 |
|
2,108 |
2,014 |
$16K |
| 84439 |
|
1,310 |
1,298 |
$16K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
209 |
203 |
$14K |
| 82570 |
|
2,359 |
2,328 |
$14K |
| 82948 |
|
2,776 |
2,239 |
$14K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
281 |
265 |
$13K |
| 86703 |
|
628 |
627 |
$13K |
| 82607 |
|
646 |
637 |
$12K |
| 0272 |
|
1,275 |
1,193 |
$12K |
| A0433 |
Advanced life support, level 2 (als 2) |
60 |
59 |
$12K |
| Z7610 |
|
1,527 |
998 |
$12K |
| 99401 |
|
787 |
751 |
$12K |
| 97010 |
|
705 |
245 |
$11K |
| 85379 |
|
874 |
829 |
$10K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
94 |
94 |
$10K |
| 85027 |
|
1,401 |
1,298 |
$10K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
440 |
432 |
$9K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
601 |
591 |
$9K |
| 76770 |
|
140 |
138 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,066 |
1,003 |
$9K |
| 84145 |
|
373 |
369 |
$9K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
752 |
677 |
$9K |
| 72040 |
|
299 |
291 |
$9K |
| 90670 |
|
1,673 |
1,671 |
$8K |
| 84702 |
|
591 |
500 |
$8K |
| 86140 |
|
1,089 |
1,043 |
$8K |
| 77065 |
Tomosynthesis, mammo |
80 |
77 |
$7K |
| 96156 |
|
505 |
494 |
$7K |
| 90648 |
|
1,188 |
1,184 |
$6K |
| 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 |
95 |
88 |
$6K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
456 |
438 |
$6K |
| 73140 |
|
249 |
244 |
$6K |
| 87070 |
|
673 |
660 |
$6K |
| 93971 |
|
62 |
60 |
$6K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
321 |
320 |
$6K |
| J2060 |
Injection, lorazepam, 2 mg |
958 |
726 |
$6K |
| 94664 |
|
401 |
302 |
$6K |
| 96367 |
|
118 |
84 |
$5K |
| 0250 |
|
1,127 |
952 |
$5K |
| 71020 |
|
171 |
72 |
$5K |
| 74019 |
|
174 |
172 |
$5K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
838 |
765 |
$5K |
| 76536 |
|
89 |
88 |
$5K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
772 |
677 |
$4K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
105 |
99 |
$4K |
| J2704 |
Injection, propofol, 10 mg |
1,354 |
1,282 |
$4K |
| 90649 |
|
785 |
785 |
$4K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
39 |
38 |
$4K |
| 80074 |
|
110 |
109 |
$4K |
| 90723 |
|
706 |
701 |
$4K |
| 90633 |
|
874 |
873 |
$4K |
| 71101 |
|
113 |
110 |
$3K |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
287 |
210 |
$3K |
| 70486 |
|
24 |
24 |
$3K |
| 82274 |
|
254 |
249 |
$3K |
| 73502 |
|
97 |
95 |
$3K |
| 0710 |
|
114 |
112 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
3,989 |
3,464 |
$3K |
| 92228 |
|
95 |
95 |
$3K |
| 96368 |
|
110 |
95 |
$3K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
48 |
48 |
$3K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
70 |
67 |
$3K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
26 |
14 |
$3K |
| 85007 |
|
837 |
756 |
$3K |
| 73080 |
|
96 |
95 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
884 |
728 |
$2K |
| 72050 |
|
67 |
67 |
$2K |
| 86592 |
|
509 |
498 |
$2K |
| 82550 |
|
282 |
254 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
17 |
15 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
164 |
164 |
$2K |
| 90680 |
|
422 |
422 |
$2K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
741 |
703 |
$2K |
| 77066 |
Tomosynthesis, mammo |
14 |
14 |
$2K |
| 86803 |
|
353 |
338 |
$2K |
| 59430 |
|
25 |
24 |
$2K |
| 74018 |
|
92 |
88 |
$2K |
| 90710 |
|
384 |
383 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
108 |
108 |
$2K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
198 |
166 |
$2K |
| 83540 |
|
186 |
182 |
$1K |
| 84153 |
|
96 |
94 |
$1K |
| 82728 |
|
123 |
121 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
20 |
12 |
$1K |
| 90696 |
|
321 |
321 |
$1K |
| 85652 |
|
418 |
386 |
$1K |
| 99384 |
|
17 |
17 |
$1K |
| 97162 |
|
27 |
27 |
$1K |
| 87490 |
|
66 |
65 |
$1K |
| 83550 |
|
113 |
112 |
$1K |
| 90734 |
|
188 |
188 |
$1K |
| 87590 |
|
77 |
75 |
$1K |
| 86901 |
|
260 |
253 |
$1K |
| 90716 |
|
212 |
211 |
$948.03 |
| 71010 |
|
53 |
18 |
$947.11 |
| 90707 |
|
185 |
185 |
$923.70 |
| 87340 |
|
148 |
131 |
$912.26 |
| 86900 |
|
259 |
252 |
$849.62 |
| 0324 |
|
15 |
15 |
$846.89 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
115 |
105 |
$841.76 |
| 86709 |
|
122 |
116 |
$830.58 |
| 86705 |
|
111 |
102 |
$777.96 |
| 29125 |
|
41 |
38 |
$713.10 |
| 90697 |
|
162 |
162 |
$691.14 |
| 80143 |
|
40 |
39 |
$675.36 |
| 80179 |
|
40 |
39 |
$675.36 |
| 29540 |
|
95 |
94 |
$666.12 |
| 87210 |
|
162 |
158 |
$635.25 |
| 97014 |
|
33 |
12 |
$632.94 |
| 87535 |
|
23 |
14 |
$623.51 |
| 90700 |
|
169 |
169 |
$573.76 |
| 0301 |
|
20 |
15 |
$496.06 |
| 92567 |
|
72 |
71 |
$492.31 |
| 80055 |
|
12 |
12 |
$479.49 |
| 86235 |
|
12 |
12 |
$394.11 |
| 85018 |
|
176 |
172 |
$391.45 |
| 87205 |
|
109 |
104 |
$391.10 |
| 99188 |
|
16 |
15 |
$356.40 |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
26 |
26 |
$272.34 |
| 86580 |
|
68 |
66 |
$269.17 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
31 |
30 |
$260.61 |
| 73590 |
|
12 |
12 |
$231.33 |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
21 |
13 |
$219.24 |
| 85013 |
|
84 |
84 |
$185.64 |
| 82553 |
|
16 |
12 |
$162.83 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13 |
13 |
$161.86 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,840 |
1,463 |
$141.90 |
| 83655 |
|
12 |
12 |
$127.06 |
| 86225 |
|
12 |
12 |
$125.91 |
| 82950 |
|
28 |
26 |
$121.65 |
| A4550 |
Surgical trays |
394 |
394 |
$116.55 |
| 90620 |
|
12 |
12 |
$108.00 |
| 84100 |
|
26 |
25 |
$100.73 |
| 82746 |
|
15 |
15 |
$89.84 |
| 69210 |
|
13 |
13 |
$89.40 |
| 86038 |
|
12 |
12 |
$89.01 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
12 |
12 |
$71.04 |
| 84550 |
|
20 |
14 |
$61.60 |
| 86431 |
|
12 |
12 |
$61.42 |
| 81000 |
|
13 |
13 |
$33.54 |
| 90658 |
|
893 |
893 |
$3.23 |
| 0271 |
|
13 |
13 |
$0.00 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
47 |
24 |
$0.00 |