| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
22,734 |
17,201 |
$3.13M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
23,791 |
19,181 |
$3.03M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
12,129 |
9,008 |
$1.36M |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12,314 |
9,211 |
$608K |
| 71045 |
Radiologic examination, chest; single view |
5,468 |
4,054 |
$573K |
| 59025 |
Fetal non-stress test |
1,750 |
1,034 |
$433K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
6,926 |
4,821 |
$189K |
| 80053 |
Comprehensive metabolic panel |
32,611 |
24,615 |
$154K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
39,511 |
29,127 |
$136K |
| 36415 |
Collection of venous blood by venipuncture |
72,985 |
54,015 |
$135K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,511 |
1,063 |
$103K |
| 71046 |
Radiologic examination, chest; 2 views |
1,522 |
1,197 |
$101K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
645 |
464 |
$96K |
| 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 |
1,151 |
1,063 |
$93K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
910 |
736 |
$91K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,541 |
1,154 |
$79K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,360 |
8,205 |
$78K |
| 80074 |
|
2,059 |
1,709 |
$74K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,527 |
1,859 |
$71K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
7,592 |
5,471 |
$67K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,324 |
2,064 |
$65K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,269 |
2,018 |
$63K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
587 |
461 |
$56K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
166 |
131 |
$54K |
| 62323 |
|
69 |
40 |
$52K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
113 |
41 |
$48K |
| 80061 |
Lipid panel |
7,777 |
6,522 |
$47K |
| 80081 |
|
679 |
558 |
$37K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,081 |
1,190 |
$36K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
602 |
537 |
$32K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
367 |
120 |
$24K |
| 84484 |
|
4,600 |
3,181 |
$23K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,104 |
2,509 |
$23K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,264 |
4,379 |
$23K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,438 |
1,187 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
559 |
202 |
$21K |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
1,273 |
1,040 |
$20K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,792 |
1,213 |
$20K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
580 |
513 |
$17K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,599 |
2,753 |
$16K |
| 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 |
292 |
224 |
$15K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
5,339 |
3,834 |
$14K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
439 |
359 |
$13K |
| 81001 |
|
8,596 |
6,379 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
189 |
112 |
$12K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
631 |
370 |
$12K |
| 82607 |
|
1,395 |
1,091 |
$10K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
641 |
597 |
$9K |
| 0240U |
|
111 |
74 |
$9K |
| 83690 |
|
2,823 |
2,154 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
645 |
473 |
$8K |
| 81025 |
|
1,509 |
1,194 |
$8K |
| 80361 |
|
596 |
410 |
$8K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
87 |
86 |
$7K |
| 94010 |
|
127 |
95 |
$5K |
| 80069 |
|
1,800 |
1,353 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,559 |
1,307 |
$5K |
| 73130 |
|
157 |
112 |
$4K |
| 52204 |
|
14 |
12 |
$4K |
| 88142 |
|
492 |
433 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
135 |
111 |
$3K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
118 |
89 |
$3K |
| 85610 |
|
2,214 |
1,190 |
$3K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
114 |
103 |
$3K |
| 80050 |
General health panel |
13 |
12 |
$3K |
| 83735 |
|
764 |
505 |
$2K |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
161 |
150 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
138 |
58 |
$2K |
| 64721 |
|
20 |
15 |
$2K |
| 82728 |
|
282 |
193 |
$2K |
| 73110 |
|
39 |
28 |
$2K |
| 86592 |
|
606 |
515 |
$2K |
| 83550 |
|
327 |
228 |
$1K |
| 84439 |
|
200 |
172 |
$1K |
| 83880 |
|
120 |
75 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
55 |
50 |
$1K |
| 83540 |
|
330 |
229 |
$984.13 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$945.12 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
19 |
$883.83 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
147 |
95 |
$772.67 |
| 85027 |
|
383 |
289 |
$706.88 |
| 84702 |
|
82 |
64 |
$676.59 |
| 73562 |
|
38 |
24 |
$673.52 |
| 84156 |
|
209 |
130 |
$590.25 |
| 83615 |
|
129 |
97 |
$586.28 |
| 82950 |
|
223 |
175 |
$569.56 |
| 82550 |
|
195 |
156 |
$532.03 |
| 76775 |
|
34 |
26 |
$490.07 |
| 87081 |
|
100 |
80 |
$484.13 |
| 84550 |
|
143 |
109 |
$477.48 |
| 87650 |
|
30 |
26 |
$454.34 |
| 82570 |
|
105 |
83 |
$443.85 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
68 |
49 |
$435.63 |
| 82746 |
|
66 |
51 |
$417.01 |
| 82043 |
|
154 |
123 |
$408.75 |
| 81003 |
|
374 |
287 |
$406.74 |
| A4217 |
Sterile water/saline, 500 ml |
1,156 |
549 |
$327.11 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,819 |
1,241 |
$323.50 |
| 86850 |
|
115 |
95 |
$302.37 |
| 84703 |
|
56 |
44 |
$300.80 |
| 77077 |
|
18 |
12 |
$234.28 |
| 80305 |
|
30 |
26 |
$188.74 |
| 85379 |
|
59 |
38 |
$142.52 |
| 99001 |
|
13 |
13 |
$115.19 |
| 87186 |
|
15 |
12 |
$69.72 |
| 86703 |
|
12 |
12 |
$65.64 |
| 82565 |
|
34 |
30 |
$22.70 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
26 |
19 |
$21.06 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,182 |
2,370 |
$10.29 |
| 82962 |
|
19 |
12 |
$6.18 |
| 86140 |
|
26 |
13 |
$5.02 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
995 |
686 |
$4.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,077 |
2,930 |
$3.30 |
| 90686 |
|
12 |
12 |
$0.09 |
| J2704 |
Injection, propofol, 10 mg |
2,291 |
1,618 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
657 |
454 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,791 |
1,010 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
596 |
401 |
$0.00 |
| 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 |
282 |
210 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
884 |
507 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
21 |
14 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
154 |
112 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
188 |
137 |
$0.00 |
| 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 |
82 |
54 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
14 |
12 |
$0.00 |
| 96376 |
|
20 |
12 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
16 |
12 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
41 |
28 |
$0.00 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
2,977 |
2,079 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
130 |
85 |
$0.00 |
| J0744 |
Injection, ciprofloxacin for intravenous infusion, 200 mg |
522 |
371 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
321 |
212 |
$0.00 |
| 0353U |
|
148 |
132 |
$0.00 |
| C1758 |
Catheter, ureteral |
35 |
24 |
$0.00 |
| 64417 |
|
32 |
25 |
$0.00 |