| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,435 |
3,855 |
$935K |
| Y7506 |
|
14,519 |
11,912 |
$819K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,434 |
4,016 |
$663K |
| X4011 |
State-specific procedure code |
4,665 |
3,691 |
$647K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
5,815 |
5,286 |
$643K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
12,990 |
11,763 |
$567K |
| 80053 |
Comprehensive metabolic panel |
20,667 |
15,681 |
$451K |
| X4006 |
|
2,087 |
1,709 |
$437K |
| 62323 |
|
3,688 |
3,130 |
$430K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20,881 |
15,886 |
$411K |
| 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 |
3,035 |
2,839 |
$386K |
| 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 |
4,040 |
3,742 |
$280K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,555 |
6,736 |
$273K |
| J3490 |
Unclassified drugs |
13,440 |
9,369 |
$251K |
| 71045 |
Radiologic examination, chest; single view |
6,736 |
5,592 |
$228K |
| G0378 |
Hospital observation service, per hour |
1,602 |
1,243 |
$183K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
4,145 |
1,642 |
$141K |
| 82550 |
|
6,895 |
4,679 |
$139K |
| 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 |
742 |
701 |
$135K |
| 72100 |
|
4,836 |
4,209 |
$125K |
| 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 |
1,525 |
1,317 |
$124K |
| 62321 |
|
950 |
799 |
$120K |
| 84484 |
|
6,300 |
4,052 |
$110K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,351 |
1,161 |
$103K |
| 81001 |
|
5,618 |
4,840 |
$102K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,279 |
1,094 |
$82K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
970 |
880 |
$80K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,339 |
3,023 |
$74K |
| 82553 |
|
4,572 |
2,837 |
$73K |
| 36415 |
Collection of venous blood by venipuncture |
9,845 |
7,074 |
$73K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,072 |
2,600 |
$66K |
| 83690 |
|
1,172 |
967 |
$66K |
| 82150 |
|
1,062 |
878 |
$65K |
| 83880 |
|
2,590 |
2,087 |
$60K |
| 85610 |
|
3,226 |
2,693 |
$59K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
546 |
428 |
$58K |
| 64483 |
|
234 |
192 |
$56K |
| 85730 |
|
3,075 |
2,568 |
$52K |
| 20610 |
|
890 |
742 |
$48K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,579 |
1,494 |
$44K |
| 80061 |
Lipid panel |
2,016 |
1,887 |
$36K |
| 72141 |
|
327 |
282 |
$32K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
697 |
611 |
$31K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,816 |
1,752 |
$28K |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
792 |
729 |
$26K |
| 72040 |
|
1,178 |
1,002 |
$25K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
899 |
855 |
$24K |
| 64493 |
|
79 |
70 |
$23K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
398 |
323 |
$20K |
| 83735 |
|
598 |
513 |
$17K |
| 52224 |
|
46 |
44 |
$17K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
720 |
682 |
$16K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
690 |
587 |
$16K |
| 80305 |
|
677 |
603 |
$16K |
| 94760 |
|
448 |
407 |
$15K |
| 20552 |
|
178 |
145 |
$13K |
| 83605 |
|
793 |
663 |
$12K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
559 |
129 |
$12K |
| 87040 |
|
939 |
741 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
706 |
652 |
$10K |
| 81025 |
|
224 |
208 |
$9K |
| G0379 |
Direct admission of patient for hospital observation care |
72 |
55 |
$9K |
| 80050 |
General health panel |
82 |
74 |
$7K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
1,888 |
1,739 |
$7K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
336 |
160 |
$6K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
604 |
41 |
$6K |
| 72202 |
|
302 |
259 |
$6K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
14 |
14 |
$5K |
| 87807 |
|
361 |
344 |
$5K |
| 52351 |
|
31 |
29 |
$5K |
| G0260 |
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
101 |
73 |
$5K |
| 73560 |
|
261 |
225 |
$5K |
| 86618 |
|
27 |
17 |
$3K |
| 82803 |
|
274 |
204 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
21 |
14 |
$3K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
27 |
25 |
$3K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
37 |
36 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
25 |
15 |
$2K |
| 81003 |
|
638 |
523 |
$2K |
| 86677 |
|
31 |
29 |
$2K |
| 36600 |
|
69 |
57 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
31 |
31 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
102 |
12 |
$1K |
| 93226 |
|
46 |
32 |
$1K |
| 73020 |
|
60 |
52 |
$1K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
14 |
13 |
$996.06 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
277 |
234 |
$908.44 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
221 |
192 |
$904.60 |
| 82607 |
|
72 |
65 |
$859.72 |
| 72131 |
|
26 |
25 |
$836.56 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
69 |
67 |
$635.24 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
164 |
132 |
$490.92 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
82 |
70 |
$452.64 |
| 85027 |
|
110 |
107 |
$441.67 |
| 84439 |
|
58 |
57 |
$439.51 |
| 27096 |
|
19 |
13 |
$406.08 |
| 84703 |
|
75 |
72 |
$374.99 |
| 71046 |
Radiologic examination, chest; 2 views |
16 |
16 |
$374.35 |
| 82948 |
|
155 |
149 |
$326.21 |
| 84153 |
|
19 |
17 |
$263.55 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
13 |
13 |
$245.18 |
| 0011A |
|
18 |
18 |
$230.40 |
| 85651 |
|
109 |
90 |
$219.75 |
| 86592 |
|
16 |
14 |
$168.29 |
| 80076 |
|
12 |
12 |
$80.70 |
| 84480 |
|
13 |
13 |
$70.43 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
2,219 |
2,061 |
$38.48 |
| 84436 |
|
13 |
13 |
$32.42 |
| 99070 |
|
2,352 |
1,940 |
$29.63 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,335 |
1,213 |
$1.22 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
188 |
130 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
19 |
16 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
104 |
86 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
36 |
29 |
$0.00 |
| 64495 |
|
39 |
33 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
14 |
13 |
$0.00 |
| 93229 |
|
16 |
15 |
$0.00 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
13 |
13 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
76 |
52 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
67 |
64 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
27 |
26 |
$0.00 |
| 64494 |
|
39 |
34 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
15 |
15 |
$0.00 |
| G1007 |
Clinical decision support mechanism aim specialty health, as defined by the medicare appropriate use criteria program |
18 |
12 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
12 |
12 |
$0.00 |