| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,077 |
885 |
$281K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
5,478 |
3,655 |
$92K |
| 80053 |
Comprehensive metabolic panel |
5,036 |
3,229 |
$61K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
746 |
264 |
$53K |
| 87070 |
|
523 |
363 |
$49K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
769 |
553 |
$47K |
| 36415 |
Collection of venous blood by venipuncture |
439 |
320 |
$40K |
| 81001 |
|
3,525 |
2,525 |
$40K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,912 |
1,249 |
$33K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,808 |
1,203 |
$23K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
289 |
237 |
$21K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
788 |
590 |
$18K |
| 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 |
391 |
299 |
$16K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,332 |
336 |
$15K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,191 |
891 |
$14K |
| 85027 |
|
7,344 |
4,324 |
$12K |
| 71046 |
Radiologic examination, chest; 2 views |
829 |
600 |
$12K |
| 87088 |
|
640 |
474 |
$12K |
| 71045 |
Radiologic examination, chest; single view |
3,274 |
2,136 |
$9K |
| 73562 |
|
206 |
143 |
$7K |
| 11043 |
|
99 |
37 |
$7K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,007 |
3,556 |
$7K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
45 |
26 |
$7K |
| 81003 |
|
653 |
463 |
$7K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
119 |
100 |
$6K |
| 81025 |
|
940 |
760 |
$6K |
| 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 |
130 |
97 |
$6K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
646 |
480 |
$5K |
| 74018 |
|
43 |
25 |
$5K |
| 84702 |
|
135 |
92 |
$5K |
| 93971 |
|
20 |
14 |
$4K |
| 82565 |
|
24 |
16 |
$3K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,181 |
868 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
4,042 |
2,497 |
$2K |
| 72110 |
|
17 |
13 |
$2K |
| 85610 |
|
1,501 |
1,048 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
179 |
71 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
190 |
139 |
$1K |
| 73030 |
|
142 |
103 |
$1K |
| 87210 |
|
36 |
27 |
$1K |
| 72050 |
|
12 |
12 |
$1K |
| 72100 |
|
114 |
101 |
$1K |
| 84484 |
|
3,030 |
1,732 |
$1K |
| 82805 |
|
896 |
622 |
$948.94 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
103 |
91 |
$870.53 |
| 83880 |
|
988 |
670 |
$765.17 |
| 97161 |
|
116 |
81 |
$717.05 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
128 |
82 |
$676.31 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
865 |
569 |
$588.88 |
| 86900 |
|
223 |
160 |
$530.43 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,005 |
2,112 |
$499.82 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
581 |
412 |
$457.11 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$340.66 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
13 |
13 |
$273.53 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
350 |
254 |
$255.76 |
| 80047 |
|
39 |
31 |
$166.52 |
| 74019 |
|
14 |
12 |
$161.96 |
| 87040 |
|
495 |
248 |
$43.05 |
| 73502 |
|
13 |
12 |
$26.62 |
| 36000 |
|
363 |
286 |
$10.96 |
| 83735 |
|
985 |
653 |
$4.93 |
| 85730 |
|
1,298 |
932 |
$0.00 |
| A9270 |
Non-covered item or service |
4,987 |
1,363 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,427 |
1,007 |
$0.00 |
| 83690 |
|
1,182 |
857 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,537 |
890 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
375 |
232 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
665 |
489 |
$0.00 |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
31 |
24 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
348 |
246 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
636 |
443 |
$0.00 |
| 83605 |
|
972 |
646 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
143 |
51 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
411 |
273 |
$0.00 |
| 96376 |
|
183 |
129 |
$0.00 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
137 |
102 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
189 |
126 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
64 |
40 |
$0.00 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
43 |
36 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
29 |
25 |
$0.00 |
| 87485 |
|
16 |
12 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
116 |
67 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
18 |
13 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
481 |
349 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,363 |
843 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
651 |
423 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,199 |
852 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
588 |
380 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
345 |
211 |
$0.00 |
| 80164 |
|
15 |
12 |
$0.00 |
| 73630 |
|
29 |
13 |
$0.00 |
| 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 |
12 |
12 |
$0.00 |
| 80061 |
Lipid panel |
16 |
12 |
$0.00 |
| 85378 |
|
12 |
12 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
19 |
12 |
$0.00 |
| G8979 |
Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
13 |
13 |
$0.00 |
| 93017 |
|
32 |
25 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
18 |
13 |
$0.00 |