| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,876 |
3,202 |
$377K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,221 |
4,500 |
$333K |
| 80053 |
Comprehensive metabolic panel |
4,930 |
3,835 |
$314K |
| 36415 |
Collection of venous blood by venipuncture |
5,196 |
3,695 |
$243K |
| 94760 |
|
5,398 |
4,720 |
$240K |
| A9270 |
Non-covered item or service |
3,011 |
2,118 |
$211K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,513 |
996 |
$188K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,424 |
2,177 |
$182K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,295 |
1,033 |
$168K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,883 |
1,313 |
$153K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,438 |
934 |
$139K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,601 |
1,242 |
$131K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,203 |
871 |
$131K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,553 |
1,252 |
$112K |
| J3490 |
Unclassified drugs |
503 |
315 |
$103K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,112 |
828 |
$99K |
| J2704 |
Injection, propofol, 10 mg |
488 |
386 |
$96K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
359 |
217 |
$91K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,352 |
944 |
$90K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,729 |
1,489 |
$89K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
801 |
652 |
$87K |
| 83690 |
|
1,022 |
815 |
$85K |
| 81001 |
|
1,628 |
1,346 |
$83K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
898 |
543 |
$76K |
| 84484 |
|
1,200 |
751 |
$74K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,579 |
1,428 |
$74K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,358 |
1,030 |
$72K |
| 71046 |
Radiologic examination, chest; 2 views |
937 |
797 |
$71K |
| 80061 |
Lipid panel |
1,010 |
891 |
$67K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
344 |
273 |
$63K |
| 81025 |
|
716 |
592 |
$62K |
| 81003 |
|
1,092 |
937 |
$61K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
650 |
448 |
$59K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
523 |
395 |
$58K |
| 70450 |
Computed tomography, head or brain; without contrast material |
448 |
375 |
$56K |
| 71045 |
Radiologic examination, chest; single view |
820 |
659 |
$54K |
| 94761 |
|
865 |
694 |
$53K |
| G0378 |
Hospital observation service, per hour |
301 |
138 |
$49K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
808 |
676 |
$46K |
| 83735 |
|
472 |
360 |
$46K |
| 82550 |
|
572 |
432 |
$45K |
| 85027 |
|
1,017 |
767 |
$45K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
225 |
184 |
$42K |
| 96376 |
|
237 |
168 |
$38K |
| 85610 |
|
674 |
506 |
$37K |
| 87040 |
|
468 |
211 |
$34K |
| 83605 |
|
422 |
310 |
$34K |
| 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 |
298 |
203 |
$33K |
| 80076 |
|
339 |
284 |
$32K |
| 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 |
308 |
228 |
$32K |
| 73630 |
|
283 |
237 |
$31K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
562 |
502 |
$29K |
| 84703 |
|
485 |
387 |
$29K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
165 |
112 |
$29K |
| 73610 |
|
174 |
135 |
$28K |
| 82553 |
|
440 |
334 |
$28K |
| 80074 |
|
486 |
442 |
$28K |
| 88142 |
|
307 |
257 |
$23K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
79 |
41 |
$23K |
| 86850 |
|
290 |
235 |
$22K |
| 86901 |
|
291 |
236 |
$21K |
| 86900 |
|
291 |
236 |
$21K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
133 |
113 |
$21K |
| 85730 |
|
358 |
276 |
$20K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
389 |
282 |
$20K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
298 |
251 |
$20K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
300 |
252 |
$20K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
516 |
302 |
$20K |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
55 |
26 |
$19K |
| 73130 |
|
172 |
142 |
$16K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
155 |
93 |
$16K |
| 82607 |
|
230 |
201 |
$16K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
173 |
141 |
$15K |
| 73560 |
|
88 |
71 |
$14K |
| 86780 |
|
408 |
370 |
$13K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
38 |
34 |
$13K |
| 87186 |
|
232 |
177 |
$12K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
219 |
60 |
$12K |
| 84439 |
|
130 |
121 |
$11K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
217 |
197 |
$11K |
| 73030 |
|
125 |
99 |
$10K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
117 |
99 |
$10K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
154 |
117 |
$10K |
| 96367 |
|
162 |
90 |
$10K |
| 87081 |
|
306 |
250 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
288 |
239 |
$8K |
| 87077 |
|
144 |
123 |
$8K |
| 85651 |
|
128 |
102 |
$8K |
| 59025 |
Fetal non-stress test |
79 |
26 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
48 |
43 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
105 |
67 |
$7K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
52 |
48 |
$7K |
| 83880 |
|
77 |
64 |
$7K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
17 |
14 |
$7K |
| 76830 |
Ultrasound, transvaginal |
29 |
26 |
$6K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
83 |
61 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
39 |
$5K |
| 73562 |
|
43 |
41 |
$5K |
| 87147 |
|
151 |
124 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
28 |
28 |
$5K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
101 |
75 |
$5K |
| 82728 |
|
132 |
118 |
$5K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
66 |
51 |
$5K |
| 86803 |
|
45 |
39 |
$4K |
| 87799 |
|
63 |
53 |
$4K |
| 84550 |
|
66 |
53 |
$4K |
| 87512 |
|
63 |
53 |
$4K |
| 87481 |
|
63 |
53 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
63 |
53 |
$4K |
| 82043 |
|
46 |
40 |
$4K |
| 82565 |
|
85 |
69 |
$4K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
64 |
51 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$4K |
| 88342 |
|
43 |
36 |
$4K |
| 73502 |
|
37 |
36 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
31 |
16 |
$3K |
| 84520 |
|
48 |
39 |
$3K |
| 84702 |
|
17 |
14 |
$3K |
| 83615 |
|
33 |
28 |
$3K |
| 95886 |
|
14 |
14 |
$3K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
53 |
29 |
$3K |
| 73110 |
|
27 |
25 |
$3K |
| 72110 |
|
31 |
28 |
$2K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
15 |
13 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
16 |
12 |
$1K |
| 83540 |
|
18 |
14 |
$1K |
| 76801 |
|
18 |
13 |
$1K |
| 84460 |
|
16 |
15 |
$1K |
| 82746 |
|
29 |
28 |
$1K |
| 85379 |
|
13 |
13 |
$977.82 |
| 86038 |
|
29 |
26 |
$910.07 |
| 86140 |
|
16 |
12 |
$774.96 |
| 82150 |
|
12 |
12 |
$660.03 |
| 83550 |
|
13 |
12 |
$485.03 |
| 83655 |
|
18 |
17 |
$242.26 |
| J7050 |
Infusion, normal saline solution, 250 cc |
18 |
12 |
$180.34 |
| 85018 |
|
13 |
12 |
$142.21 |
| J1720 |
Injection, hydrocortisone sodium succinate, up to 100 mg |
25 |
12 |
$0.00 |