| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
57,762 |
47,408 |
$8.82M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
82,412 |
52,850 |
$3.78M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
14,631 |
13,489 |
$3.49M |
| 90834 |
Psychotherapy, 45 minutes with patient |
32,170 |
16,972 |
$1.93M |
| 90832 |
Psychotherapy, 30 minutes with patient |
42,116 |
23,895 |
$1.67M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
10,114 |
9,451 |
$1.48M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41,848 |
34,163 |
$1.33M |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
43,426 |
14,046 |
$1.25M |
| 90791 |
Psychiatric diagnostic evaluation |
13,349 |
9,823 |
$1.14M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,235 |
2,916 |
$1.06M |
| H2017 |
Psychosocial rehabilitation services, per 15 minutes |
11,384 |
698 |
$754K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24,292 |
20,245 |
$628K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
14,061 |
4,308 |
$308K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
518 |
482 |
$275K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
5,586 |
4,684 |
$265K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,727 |
2,116 |
$207K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
291 |
251 |
$189K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,956 |
1,837 |
$163K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
3,864 |
1,974 |
$150K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
24,803 |
22,736 |
$98K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,493 |
3,226 |
$82K |
| G0378 |
Hospital observation service, per hour |
396 |
237 |
$80K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
28,177 |
24,636 |
$76K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,921 |
1,442 |
$61K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,787 |
8,729 |
$56K |
| 99215 |
Prolong outpt/office vis |
957 |
809 |
$42K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
70 |
64 |
$42K |
| 90837 |
Psychotherapy, 53 minutes with patient |
261 |
172 |
$33K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,504 |
4,351 |
$33K |
| 80053 |
Comprehensive metabolic panel |
9,012 |
8,215 |
$33K |
| 71045 |
Radiologic examination, chest; single view |
2,629 |
2,405 |
$33K |
| H0038 |
Self-help/peer services, per 15 minutes |
1,448 |
474 |
$29K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,133 |
1,027 |
$24K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,992 |
3,483 |
$21K |
| 93016 |
|
2,073 |
1,934 |
$17K |
| 99442 |
|
3,668 |
3,501 |
$16K |
| 43248 |
|
27 |
24 |
$13K |
| 84484 |
|
954 |
727 |
$12K |
| 99233 |
Prolong inpt eval add15 m |
350 |
103 |
$11K |
| H0034 |
Medication training and support, per 15 minutes |
614 |
313 |
$10K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
98 |
83 |
$8K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
12 |
12 |
$8K |
| 83690 |
|
2,164 |
2,003 |
$8K |
| 93018 |
|
1,012 |
927 |
$7K |
| G0426 |
Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth |
320 |
264 |
$7K |
| 3008F |
|
11,749 |
8,502 |
$7K |
| 95886 |
|
707 |
506 |
$6K |
| 90899 |
|
407 |
237 |
$6K |
| 83970 |
|
445 |
427 |
$6K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
911 |
855 |
$5K |
| 3074F |
|
5,499 |
4,690 |
$5K |
| 3078F |
|
4,728 |
4,046 |
$5K |
| 83735 |
|
856 |
824 |
$4K |
| G0427 |
Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth |
277 |
222 |
$4K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
433 |
414 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,911 |
1,755 |
$4K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
498 |
464 |
$4K |
| 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 |
60 |
49 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
596 |
561 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
58 |
55 |
$3K |
| 84703 |
|
700 |
656 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
85 |
75 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
612 |
559 |
$3K |
| 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 |
38 |
37 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
71 |
66 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,238 |
2,926 |
$2K |
| 84466 |
|
544 |
525 |
$2K |
| 82728 |
|
438 |
425 |
$2K |
| 87276 |
|
424 |
392 |
$2K |
| 77336 |
|
62 |
25 |
$2K |
| 99441 |
|
762 |
740 |
$2K |
| 85027 |
|
736 |
684 |
$2K |
| 80076 |
|
734 |
695 |
$2K |
| 82607 |
|
326 |
314 |
$2K |
| 81001 |
|
2,175 |
2,029 |
$1K |
| 84590 |
|
306 |
293 |
$1K |
| G0425 |
Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth |
78 |
74 |
$1K |
| 87275 |
|
424 |
392 |
$1K |
| 3079F |
|
786 |
717 |
$1K |
| H2000 |
Comprehensive multidisciplinary evaluation |
16 |
15 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
19 |
16 |
$1K |
| 83540 |
|
563 |
543 |
$1K |
| 82746 |
|
182 |
173 |
$810.12 |
| 86140 |
|
153 |
148 |
$720.21 |
| 84597 |
|
98 |
93 |
$567.80 |
| 81596 |
|
16 |
12 |
$552.18 |
| 84134 |
|
86 |
81 |
$548.43 |
| 84425 |
|
47 |
43 |
$507.50 |
| 87522 |
Neg quan hep c or qual rna |
45 |
41 |
$426.91 |
| 84446 |
|
74 |
70 |
$426.16 |
| 85610 |
|
210 |
190 |
$415.22 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
18 |
14 |
$404.17 |
| 81003 |
|
604 |
550 |
$317.83 |
| 3080F |
|
167 |
149 |
$290.00 |
| 3075F |
|
261 |
232 |
$290.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
43 |
39 |
$279.56 |
| 99443 |
|
53 |
52 |
$276.10 |
| 3077F |
|
141 |
122 |
$240.00 |
| 82077 |
|
56 |
51 |
$201.23 |
| 85652 |
|
77 |
74 |
$159.84 |
| 82248 |
|
40 |
40 |
$158.42 |
| 82105 |
|
16 |
12 |
$78.79 |
| 82525 |
|
12 |
12 |
$73.66 |
| 84630 |
|
12 |
12 |
$67.61 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
13 |
13 |
$66.08 |
| 86803 |
|
15 |
15 |
$48.95 |
| 82150 |
|
27 |
27 |
$32.55 |
| 87081 |
|
335 |
310 |
$30.50 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
37 |
12 |
$28.11 |
| 86677 |
|
14 |
13 |
$23.13 |
| G9011 |
Coordinated care fee, risk adjusted maintenance, level 5 |
5,837 |
3,228 |
$0.06 |
| G9010 |
Coordinated care fee, risk adjusted maintenance, level 4 |
82,233 |
34,555 |
$0.03 |
| G9006 |
Coordinated care fee, home monitoring |
17,505 |
9,379 |
$0.02 |
| G9004 |
Coordinated care fee, risk adjusted low, initial |
11,041 |
8,695 |
$0.01 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
39 |
38 |
$0.00 |
| C7901 |
Service for diagnosis, evaluation, or treatment of a mental health or substance use disorder, 30-60 minutes, provided remotely by hospital staff who are licensed to provided mental health services under applicable state law(s), when the patient is in their home, and there is no associated professional service |
42 |
24 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
134 |
116 |
$0.00 |
| G9005 |
Coordinated care fee, risk adjusted maintenance |
20,223 |
9,282 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
411 |
390 |
$0.00 |
| A9270 |
Non-covered item or service |
129 |
76 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
14 |
14 |
$0.00 |