| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,132 |
1,018 |
$300K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,141 |
1,065 |
$243K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
531 |
462 |
$122K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
107 |
94 |
$94K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
105 |
98 |
$61K |
| 70450 |
Computed tomography, head or brain; without contrast material |
204 |
188 |
$57K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
50 |
47 |
$19K |
| G0378 |
Hospital observation service, per hour |
90 |
44 |
$15K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
88 |
86 |
$10K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
101 |
96 |
$7K |
| 76497 |
|
13 |
13 |
$5K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
384 |
332 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
64 |
59 |
$948.82 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
406 |
353 |
$706.86 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
181 |
180 |
$280.59 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
487 |
433 |
$275.29 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
434 |
370 |
$78.56 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
230 |
220 |
$77.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
311 |
271 |
$36.82 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
357 |
306 |
$29.84 |
| 71045 |
Radiologic examination, chest; single view |
437 |
385 |
$28.83 |
| 80053 |
Comprehensive metabolic panel |
939 |
769 |
$14.84 |
| 85027 |
|
1,148 |
900 |
$13.71 |
| 84484 |
|
322 |
248 |
$13.55 |
| 81025 |
|
127 |
124 |
$10.28 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
911 |
550 |
$8.86 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
461 |
381 |
$8.00 |
| 81002 |
|
613 |
561 |
$6.35 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
213 |
173 |
$5.82 |
| J2060 |
Injection, lorazepam, 2 mg |
267 |
210 |
$5.21 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
77 |
63 |
$5.18 |
| 83690 |
|
297 |
262 |
$4.86 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
109 |
99 |
$0.00 |
| 80305 |
|
140 |
127 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
294 |
217 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
110 |
84 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
33 |
31 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
185 |
146 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
115 |
110 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
29 |
25 |
$0.00 |
| 84702 |
|
32 |
29 |
$0.00 |
| 85610 |
|
174 |
139 |
$0.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
12 |
12 |
$0.00 |
| 96367 |
|
14 |
14 |
$0.00 |
| 85730 |
|
103 |
85 |
$0.00 |
| 82553 |
|
113 |
92 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
180 |
150 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
119 |
113 |
$0.00 |
| 83605 |
|
60 |
44 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
155 |
124 |
$0.00 |
| 83735 |
|
328 |
269 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
82 |
73 |
$0.00 |
| 85379 |
|
70 |
64 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
105 |
89 |
$0.00 |
| 87807 |
|
63 |
62 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
163 |
148 |
$0.00 |
| 84703 |
|
242 |
223 |
$0.00 |
| 87040 |
|
81 |
65 |
$0.00 |
| 83880 |
|
35 |
31 |
$0.00 |
| J3490 |
Unclassified drugs |
168 |
93 |
$0.00 |
| 82550 |
|
209 |
173 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
253 |
229 |
$0.00 |
| 82150 |
|
15 |
12 |
$0.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
12 |
12 |
$0.00 |
| 96376 |
|
77 |
66 |
$0.00 |
| 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 |
36 |
34 |
$0.00 |