| Code | Description | Claims | Beneficiaries | Total Paid |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
194,045 |
161,579 |
$12.64M |
| X4011 |
State-specific procedure code |
17,841 |
16,724 |
$8.65M |
| X4003 |
|
94,446 |
81,206 |
$5.98M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
16,956 |
15,260 |
$3.91M |
| 80053 |
Comprehensive metabolic panel |
62,639 |
53,378 |
$3.20M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
19,391 |
17,532 |
$3.09M |
| 94761 |
|
25,225 |
22,612 |
$2.75M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
60,201 |
50,404 |
$2.43M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
7,820 |
6,954 |
$2.28M |
| 81001 |
|
10,269 |
9,429 |
$1.08M |
| Y7506 |
|
934 |
877 |
$979K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
9,149 |
7,979 |
$942K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
13,160 |
10,952 |
$733K |
| D7999 |
|
436 |
394 |
$529K |
| Y7507 |
|
1,297 |
1,174 |
$514K |
| 83690 |
|
4,352 |
3,950 |
$411K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,088 |
3,487 |
$386K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,880 |
1,688 |
$334K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,440 |
1,323 |
$305K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
3,273 |
3,026 |
$304K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
3,186 |
3,017 |
$303K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
981 |
837 |
$287K |
| 71046 |
Radiologic examination, chest; 2 views |
1,722 |
1,558 |
$280K |
| J3490 |
Unclassified drugs |
12,360 |
9,587 |
$263K |
| 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 |
1,670 |
1,508 |
$229K |
| 84484 |
|
6,074 |
4,934 |
$217K |
| 71045 |
Radiologic examination, chest; single view |
4,225 |
3,733 |
$214K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
7,331 |
6,543 |
$208K |
| 87088 |
|
3,220 |
2,914 |
$207K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,323 |
5,780 |
$180K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
7,943 |
7,478 |
$176K |
| 81003 |
|
9,367 |
7,437 |
$173K |
| 83735 |
|
6,886 |
5,513 |
$168K |
| X4006 |
|
115 |
98 |
$160K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,035 |
592 |
$158K |
| 84436 |
|
1,823 |
1,663 |
$154K |
| 85610 |
|
2,836 |
2,512 |
$153K |
| 70310 |
|
81 |
78 |
$116K |
| 92567 |
|
2,952 |
2,745 |
$94K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,416 |
880 |
$94K |
| 84702 |
|
1,347 |
1,207 |
$86K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,321 |
1,139 |
$79K |
| 86140 |
|
498 |
462 |
$75K |
| 81002 |
|
955 |
664 |
$75K |
| 85730 |
|
1,822 |
1,652 |
$71K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
879 |
786 |
$69K |
| 87081 |
|
740 |
726 |
$69K |
| 81025 |
|
888 |
815 |
$68K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
946 |
890 |
$63K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
96 |
96 |
$54K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
581 |
506 |
$50K |
| 73630 |
|
1,592 |
1,181 |
$47K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,007 |
847 |
$44K |
| 86900 |
|
616 |
535 |
$42K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,339 |
3,169 |
$41K |
| G0378 |
Hospital observation service, per hour |
93 |
78 |
$35K |
| 82553 |
|
150 |
146 |
$33K |
| 82550 |
|
164 |
158 |
$33K |
| 80061 |
Lipid panel |
3,263 |
3,041 |
$32K |
| 83880 |
|
935 |
816 |
$32K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
328 |
312 |
$30K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
751 |
554 |
$29K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
994 |
816 |
$26K |
| 86850 |
|
829 |
747 |
$24K |
| 85027 |
|
473 |
426 |
$24K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
295 |
277 |
$23K |
| 80143 |
|
1,612 |
1,478 |
$22K |
| 80179 |
|
1,611 |
1,479 |
$22K |
| 82077 |
|
1,761 |
1,608 |
$22K |
| 29581 |
|
469 |
119 |
$21K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
395 |
358 |
$20K |
| 87430 |
|
61 |
56 |
$19K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
339 |
307 |
$18K |
| 88312 |
|
277 |
244 |
$18K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
110 |
96 |
$18K |
| 59025 |
Fetal non-stress test |
135 |
112 |
$18K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,678 |
1,585 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
251 |
247 |
$17K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
168 |
136 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,076 |
1,946 |
$16K |
| 97597 |
|
288 |
212 |
$15K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
728 |
694 |
$15K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
128 |
103 |
$14K |
| 90870 |
|
80 |
45 |
$14K |
| 86901 |
|
616 |
535 |
$13K |
| 96367 |
|
219 |
103 |
$13K |
| 83655 |
|
1,261 |
1,095 |
$13K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
326 |
310 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
561 |
536 |
$12K |
| 84439 |
|
1,854 |
1,710 |
$12K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
106 |
92 |
$12K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
173 |
150 |
$11K |
| 11721 |
|
4,520 |
3,770 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
344 |
292 |
$11K |
| 70450 |
Computed tomography, head or brain; without contrast material |
141 |
124 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
14,226 |
10,276 |
$10K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
41 |
36 |
$8K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
69 |
57 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
79 |
51 |
$7K |
| 77336 |
|
105 |
50 |
$7K |
| 83605 |
|
607 |
539 |
$7K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
117 |
114 |
$6K |
| 86780 |
|
724 |
699 |
$6K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
675 |
326 |
$6K |
| 82728 |
|
709 |
650 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
88 |
80 |
$5K |
| 97602 |
|
128 |
89 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
99 |
89 |
$5K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
66 |
61 |
$5K |
| 87660 |
|
310 |
278 |
$5K |
| 36592 |
|
122 |
79 |
$4K |
| 93296 |
|
475 |
450 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
24 |
24 |
$4K |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
244 |
134 |
$4K |
| 80081 |
|
63 |
62 |
$4K |
| 92557 |
|
91 |
80 |
$4K |
| 76820 |
|
141 |
119 |
$4K |
| 87634 |
|
60 |
42 |
$3K |
| 11730 |
|
33 |
25 |
$3K |
| 85007 |
|
42 |
40 |
$3K |
| 0352U |
|
38 |
37 |
$3K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
24 |
24 |
$3K |
| 62323 |
|
38 |
29 |
$3K |
| 69210 |
|
178 |
147 |
$3K |
| 83550 |
|
576 |
524 |
$3K |
| 87480 |
|
190 |
177 |
$3K |
| 87040 |
|
153 |
119 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
175 |
164 |
$2K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
115 |
103 |
$2K |
| 86803 |
|
201 |
192 |
$2K |
| 83540 |
|
593 |
538 |
$2K |
| 85652 |
|
105 |
94 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
40 |
26 |
$2K |
| 93922 |
|
67 |
53 |
$2K |
| 93880 |
|
29 |
25 |
$2K |
| 90715 |
|
59 |
57 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
27 |
26 |
$2K |
| 83615 |
|
524 |
419 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
153 |
121 |
$1K |
| 43249 |
|
13 |
12 |
$1K |
| 20611 |
|
15 |
12 |
$1K |
| 17311 |
|
14 |
12 |
$1K |
| 97032 |
|
161 |
64 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
12 |
12 |
$926.00 |
| 82746 |
|
149 |
141 |
$920.22 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
13 |
12 |
$893.67 |
| 87150 |
|
41 |
37 |
$877.49 |
| 82607 |
|
138 |
131 |
$876.93 |
| 94726 |
|
13 |
13 |
$857.08 |
| 87340 |
|
149 |
140 |
$852.91 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
59 |
56 |
$821.22 |
| 95115 |
|
118 |
49 |
$775.59 |
| 94060 |
|
12 |
12 |
$719.52 |
| 92552 |
|
39 |
39 |
$683.12 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
83 |
73 |
$679.17 |
| 86762 |
|
64 |
61 |
$613.09 |
| 87186 |
|
105 |
79 |
$588.13 |
| 87077 |
|
103 |
78 |
$581.34 |
| 87510 |
|
44 |
39 |
$566.35 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
46 |
45 |
$548.35 |
| 87070 |
|
152 |
133 |
$537.06 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
445 |
364 |
$533.19 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
47 |
38 |
$517.23 |
| 87075 |
|
121 |
108 |
$502.64 |
| 0071A |
|
32 |
29 |
$480.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62 |
50 |
$412.67 |
| 85018 |
|
311 |
283 |
$374.01 |
| 87205 |
|
161 |
121 |
$373.95 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
15 |
13 |
$310.31 |
| 0072A |
|
16 |
15 |
$280.00 |
| J2274 |
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg |
14 |
12 |
$272.80 |
| 85045 |
|
166 |
157 |
$257.31 |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
117 |
38 |
$252.55 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
37 |
30 |
$237.18 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
74 |
61 |
$224.64 |
| 92555 |
|
29 |
28 |
$192.33 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
15 |
12 |
$187.34 |
| 80305 |
|
26 |
25 |
$168.96 |
| 97162 |
|
18 |
12 |
$142.93 |
| 85046 |
|
41 |
40 |
$128.05 |
| 87807 |
|
15 |
14 |
$97.16 |
| 82962 |
|
76 |
53 |
$94.42 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
27 |
25 |
$90.15 |
| 88720 |
|
15 |
12 |
$71.33 |
| 93299 |
|
31 |
28 |
$66.61 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
466 |
360 |
$58.48 |
| 92558 |
|
42 |
28 |
$57.19 |
| 82947 |
|
15 |
12 |
$54.14 |
| 82950 |
|
12 |
12 |
$37.14 |
| J7614 |
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg |
15 |
12 |
$34.20 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
14 |
12 |
$12.91 |
| 94729 |
|
12 |
12 |
$11.75 |
| G1010 |
Clinical decision support mechanism stanson, as defined by the medicare appropriate use criteria program |
968 |
613 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
13 |
12 |
$0.00 |
| G9920 |
Screening performed and negative |
16 |
14 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
14 |
12 |
$0.00 |
| 90686 |
|
58 |
52 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
101 |
89 |
$0.00 |
| 80050 |
General health panel |
42 |
41 |
$0.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
14 |
13 |
$0.00 |
| A9270 |
Non-covered item or service |
207 |
26 |
$0.00 |
| 94760 |
|
17 |
12 |
$0.00 |
| 92551 |
|
13 |
13 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
13 |
12 |
$0.00 |