| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,784 |
7,158 |
$2.70M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,843 |
3,296 |
$1.02M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
14,147 |
13,403 |
$782K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
3,165 |
3,027 |
$675K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,223 |
896 |
$376K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
4,017 |
3,840 |
$315K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
762 |
661 |
$208K |
| 71045 |
Radiologic examination, chest; single view |
3,168 |
2,684 |
$163K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
208 |
139 |
$157K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
22,248 |
19,835 |
$115K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,464 |
2,817 |
$114K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,672 |
2,529 |
$103K |
| G0378 |
Hospital observation service, per hour |
251 |
169 |
$100K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
855 |
830 |
$91K |
| 87400 |
|
918 |
889 |
$88K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
147 |
143 |
$88K |
| 80053 |
Comprehensive metabolic panel |
7,337 |
6,140 |
$82K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
9,974 |
8,015 |
$80K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,023 |
886 |
$78K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
30 |
30 |
$78K |
| 71046 |
Radiologic examination, chest; 2 views |
1,399 |
1,300 |
$69K |
| 87430 |
|
884 |
854 |
$51K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
500 |
486 |
$30K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
504 |
430 |
$30K |
| 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 |
279 |
228 |
$30K |
| CP008 |
|
538 |
498 |
$24K |
| 84484 |
|
1,915 |
1,249 |
$20K |
| 83880 |
|
723 |
597 |
$17K |
| 11045 |
|
41 |
12 |
$16K |
| 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 |
156 |
150 |
$15K |
| 81025 |
|
1,453 |
1,293 |
$14K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
227 |
217 |
$13K |
| 20610 |
|
375 |
286 |
$13K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
74 |
64 |
$12K |
| 81001 |
|
3,450 |
3,031 |
$12K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
61 |
50 |
$12K |
| 74018 |
|
140 |
128 |
$11K |
| 99152 |
|
538 |
438 |
$10K |
| 87807 |
|
303 |
300 |
$9K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
156 |
125 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,839 |
1,452 |
$8K |
| 84703 |
|
603 |
545 |
$8K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
227 |
225 |
$7K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,285 |
1,869 |
$7K |
| 83690 |
|
1,182 |
1,009 |
$6K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
144 |
118 |
$6K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
227 |
225 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,128 |
970 |
$5K |
| 85610 |
|
2,126 |
1,824 |
$4K |
| 85730 |
|
1,587 |
1,390 |
$4K |
| 73030 |
|
123 |
109 |
$4K |
| 83735 |
|
839 |
556 |
$4K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,502 |
1,385 |
$3K |
| 73130 |
|
14 |
13 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$2K |
| 81003 |
|
1,220 |
1,099 |
$2K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,019 |
893 |
$2K |
| 97597 |
|
20 |
14 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,231 |
1,676 |
$2K |
| 87077 |
|
273 |
239 |
$2K |
| 81002 |
|
1,037 |
919 |
$2K |
| 73502 |
|
49 |
41 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
166 |
143 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
29 |
27 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,569 |
1,369 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
463 |
387 |
$1K |
| 87186 |
|
213 |
186 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
515 |
398 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
10,610 |
8,230 |
$917.28 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
223 |
135 |
$903.19 |
| 94760 |
|
53 |
39 |
$884.00 |
| 84153 |
|
29 |
28 |
$871.12 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
316 |
235 |
$870.87 |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,142 |
625 |
$852.12 |
| 83605 |
|
102 |
74 |
$832.57 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
392 |
276 |
$774.35 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
351 |
301 |
$747.13 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
679 |
556 |
$715.82 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
66 |
52 |
$711.09 |
| 82565 |
|
835 |
762 |
$709.77 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
44 |
44 |
$707.42 |
| 87070 |
|
136 |
125 |
$642.62 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,227 |
1,818 |
$629.58 |
| 85379 |
|
77 |
67 |
$618.69 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
73 |
41 |
$570.85 |
| 94010 |
|
39 |
38 |
$526.23 |
| 73562 |
|
14 |
12 |
$486.44 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
309 |
259 |
$450.20 |
| 84132 |
|
537 |
461 |
$447.77 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,442 |
1,218 |
$429.68 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
146 |
118 |
$388.52 |
| A4615 |
Cannula, nasal |
1,171 |
990 |
$371.53 |
| 73560 |
|
14 |
12 |
$342.78 |
| 84295 |
|
478 |
414 |
$317.53 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$303.39 |
| 86850 |
|
41 |
36 |
$293.65 |
| J1644 |
Injection, heparin sodium, per 1000 units |
247 |
142 |
$233.97 |
| 85014 |
|
552 |
470 |
$211.42 |
| 82435 |
|
470 |
410 |
$208.08 |
| 84520 |
|
469 |
410 |
$203.80 |
| 82947 |
|
475 |
415 |
$190.76 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,874 |
1,557 |
$187.05 |
| 99153 |
Mod sedat endo service >5yrs |
14 |
12 |
$178.97 |
| 86901 |
|
150 |
130 |
$167.44 |
| 86900 |
|
122 |
107 |
$154.89 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
63 |
56 |
$135.31 |
| 82962 |
|
2,350 |
1,208 |
$113.31 |
| 80061 |
Lipid panel |
14 |
12 |
$104.10 |
| 51798 |
|
119 |
117 |
$90.38 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
17 |
12 |
$83.22 |
| J2704 |
Injection, propofol, 10 mg |
1,695 |
1,433 |
$81.05 |
| 84540 |
|
147 |
145 |
$67.48 |
| 94729 |
|
12 |
12 |
$48.92 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
22 |
15 |
$36.96 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
31 |
25 |
$29.09 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
20 |
12 |
$24.46 |
| J7510 |
Prednisolone oral, per 5 mg |
12 |
12 |
$8.80 |
| 85007 |
|
29 |
25 |
$3.19 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
668 |
535 |
$0.00 |
| 99490 |
Ccm add 20min |
76 |
70 |
$0.00 |
| 96376 |
|
62 |
25 |
$0.00 |
| A9270 |
Non-covered item or service |
1,362 |
587 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
86 |
76 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
225 |
133 |
$0.00 |
| C1769 |
Guide wire |
339 |
285 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
32 |
24 |
$0.00 |
| J2371 |
Injection, phenylephrine hydrochloride, 20 micrograms |
14 |
14 |
$0.00 |