| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
13,046 |
11,966 |
$2.12M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,074 |
18,106 |
$954K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,396 |
2,319 |
$226K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,647 |
1,523 |
$200K |
| 80053 |
Comprehensive metabolic panel |
14,684 |
13,089 |
$196K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,460 |
3,348 |
$161K |
| 59025 |
Fetal non-stress test |
2,475 |
2,193 |
$152K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17,876 |
15,664 |
$146K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
6,614 |
6,347 |
$130K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,498 |
1,440 |
$74K |
| 71045 |
Radiologic examination, chest; single view |
3,061 |
2,753 |
$74K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,098 |
2,782 |
$72K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,417 |
1,352 |
$68K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
305 |
297 |
$68K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
396 |
378 |
$59K |
| 81001 |
|
12,929 |
11,935 |
$47K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,305 |
1,266 |
$43K |
| 76801 |
|
586 |
481 |
$39K |
| 70450 |
Computed tomography, head or brain; without contrast material |
670 |
657 |
$37K |
| 87631 |
|
228 |
222 |
$31K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,028 |
982 |
$27K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,028 |
982 |
$27K |
| 87800 |
|
768 |
740 |
$25K |
| 84703 |
|
3,199 |
2,998 |
$23K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
230 |
219 |
$19K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
220 |
210 |
$17K |
| CP007 |
|
351 |
315 |
$16K |
| 84484 |
|
2,169 |
1,746 |
$14K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,347 |
2,038 |
$13K |
| 83880 |
|
802 |
725 |
$13K |
| 84702 |
|
991 |
746 |
$10K |
| 83690 |
|
2,170 |
1,994 |
$9K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,726 |
1,406 |
$8K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,315 |
2,648 |
$8K |
| 83605 |
|
1,469 |
1,087 |
$7K |
| 81025 |
|
1,073 |
1,037 |
$7K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
120 |
117 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,160 |
852 |
$5K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
71 |
60 |
$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 |
80 |
61 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
795 |
470 |
$3K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
914 |
785 |
$3K |
| 84112 |
|
15 |
13 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
761 |
662 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
544 |
504 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
787 |
751 |
$2K |
| 87040 |
|
572 |
320 |
$2K |
| 94760 |
|
308 |
229 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
61 |
54 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
180 |
174 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,893 |
2,455 |
$2K |
| 84145 |
|
105 |
94 |
$1K |
| 86901 |
|
656 |
593 |
$1K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
13 |
13 |
$1K |
| 87634 |
|
12 |
12 |
$758.62 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
945 |
719 |
$738.68 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$555.53 |
| 96376 |
|
298 |
207 |
$482.98 |
| 85379 |
|
59 |
56 |
$370.62 |
| 85610 |
|
162 |
152 |
$344.26 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
362 |
291 |
$330.80 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
17 |
13 |
$297.76 |
| 71046 |
Radiologic examination, chest; 2 views |
14 |
14 |
$294.75 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
708 |
654 |
$285.75 |
| 0352U |
|
77 |
74 |
$228.20 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
331 |
305 |
$165.14 |
| 85730 |
|
35 |
28 |
$111.20 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
129 |
98 |
$90.27 |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
20 |
15 |
$88.06 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
248 |
181 |
$62.00 |
| J2704 |
Injection, propofol, 10 mg |
63 |
42 |
$54.74 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
13 |
13 |
$51.30 |
| 86900 |
|
29 |
22 |
$48.17 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
37 |
37 |
$40.35 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
112 |
85 |
$38.36 |
| 36415 |
Collection of venous blood by venipuncture |
2,652 |
2,207 |
$38.22 |
| J2060 |
Injection, lorazepam, 2 mg |
17 |
14 |
$8.80 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
27 |
15 |
$8.61 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
126 |
54 |
$6.58 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
15 |
13 |
$5.28 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
14 |
13 |
$1.26 |
| A9270 |
Non-covered item or service |
3,006 |
2,718 |
$0.57 |
| 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 |
67 |
$0.00 |