| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
36,862 |
34,605 |
$9.42M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
26,083 |
24,835 |
$4.33M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,749 |
4,378 |
$1.87M |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,747 |
3,569 |
$595K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
55,965 |
48,887 |
$443K |
| 80053 |
Comprehensive metabolic panel |
40,615 |
35,679 |
$412K |
| 0240U |
|
2,359 |
2,150 |
$397K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,091 |
7,823 |
$258K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
9,084 |
7,817 |
$257K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,562 |
7,740 |
$231K |
| 36415 |
Collection of venous blood by venipuncture |
42,580 |
35,275 |
$156K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
246 |
237 |
$130K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,882 |
4,056 |
$117K |
| 70450 |
Computed tomography, head or brain; without contrast material |
739 |
701 |
$114K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,199 |
2,417 |
$101K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,615 |
1,062 |
$94K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,068 |
1,025 |
$91K |
| 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 |
1,564 |
1,281 |
$72K |
| 71046 |
Radiologic examination, chest; 2 views |
1,568 |
1,508 |
$66K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,242 |
3,082 |
$64K |
| 81001 |
|
19,694 |
18,485 |
$61K |
| G0378 |
Hospital observation service, per hour |
865 |
698 |
$58K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,557 |
1,453 |
$57K |
| 88142 |
|
1,703 |
1,556 |
$43K |
| 84484 |
|
4,195 |
3,509 |
$43K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,498 |
1,305 |
$40K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,475 |
2,506 |
$39K |
| 71045 |
Radiologic examination, chest; single view |
1,417 |
1,322 |
$37K |
| 81025 |
|
4,286 |
4,063 |
$36K |
| 86803 |
|
2,147 |
1,757 |
$33K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,483 |
1,407 |
$32K |
| 87088 |
|
2,775 |
2,395 |
$27K |
| 80061 |
Lipid panel |
1,874 |
1,801 |
$27K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
223 |
204 |
$27K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,727 |
1,607 |
$26K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
494 |
453 |
$25K |
| J7050 |
Infusion, normal saline solution, 250 cc |
8,208 |
2,076 |
$23K |
| 86592 |
|
5,012 |
4,150 |
$22K |
| J3490 |
Unclassified drugs |
9,968 |
5,756 |
$22K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,319 |
2,682 |
$18K |
| 87081 |
|
2,254 |
2,183 |
$18K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
92 |
76 |
$15K |
| 87340 |
|
1,684 |
1,397 |
$15K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
456 |
382 |
$14K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,225 |
1,158 |
$13K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
413 |
355 |
$13K |
| 97597 |
|
645 |
441 |
$13K |
| 86850 |
|
1,158 |
887 |
$12K |
| 83690 |
|
1,526 |
1,439 |
$11K |
| A9270 |
Non-covered item or service |
50,245 |
19,171 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
898 |
834 |
$10K |
| 0002A |
|
169 |
164 |
$10K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,163 |
1,932 |
$10K |
| 0001A |
|
157 |
153 |
$9K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
249 |
78 |
$9K |
| 86762 |
|
752 |
565 |
$9K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
138 |
107 |
$7K |
| 84443 |
Thyroid stimulating hormone (TSH) |
332 |
310 |
$7K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
181 |
177 |
$7K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
55 |
52 |
$6K |
| 85027 |
|
665 |
627 |
$5K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
87 |
51 |
$5K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
12 |
12 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
93 |
85 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
733 |
563 |
$4K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
61 |
61 |
$4K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,647 |
1,504 |
$3K |
| 83880 |
|
85 |
81 |
$3K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
62 |
27 |
$3K |
| 82728 |
|
186 |
180 |
$3K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,587 |
1,511 |
$3K |
| 87070 |
|
255 |
225 |
$3K |
| 86900 |
|
797 |
576 |
$3K |
| 84466 |
|
174 |
167 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
14 |
13 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,464 |
1,345 |
$2K |
| 86901 |
|
799 |
576 |
$2K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
84 |
28 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$2K |
| 87430 |
|
75 |
73 |
$1K |
| 87631 |
|
16 |
16 |
$1K |
| 83735 |
|
291 |
202 |
$1K |
| 83540 |
|
174 |
167 |
$1K |
| 29581 |
|
74 |
24 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
258 |
229 |
$1K |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,120 |
1,075 |
$1K |
| 83020 |
|
55 |
44 |
$971.59 |
| 81003 |
|
446 |
409 |
$934.85 |
| 59025 |
Fetal non-stress test |
14 |
13 |
$677.13 |
| J2704 |
Injection, propofol, 10 mg |
76 |
56 |
$582.71 |
| 80081 |
|
28 |
27 |
$558.82 |
| 29580 |
|
28 |
12 |
$557.73 |
| 82947 |
|
169 |
90 |
$372.85 |
| 82105 |
|
14 |
12 |
$341.20 |
| 82570 |
|
47 |
44 |
$260.57 |
| 96402 |
|
31 |
25 |
$255.13 |
| 82607 |
|
12 |
12 |
$240.60 |
| 82962 |
|
142 |
105 |
$227.87 |
| 84156 |
|
47 |
44 |
$184.64 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$171.36 |
| 85379 |
|
13 |
13 |
$168.00 |
| 87040 |
|
15 |
12 |
$141.46 |
| 87077 |
|
19 |
13 |
$139.58 |
| 84439 |
|
13 |
13 |
$137.15 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
35 |
25 |
$75.56 |
| 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 |
71 |
69 |
$51.77 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
25 |
25 |
$38.38 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
14 |
$8.73 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
14 |
14 |
$7.01 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
29 |
29 |
$0.00 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
16 |
13 |
$0.00 |
| 91300 |
|
171 |
147 |
$0.00 |