| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,780 |
14,121 |
$1.42M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32,329 |
18,184 |
$1.36M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,465 |
7,816 |
$1.31M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
11,928 |
8,756 |
$907K |
| 64493 |
|
1,055 |
439 |
$559K |
| 64635 |
|
524 |
153 |
$511K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
591 |
128 |
$226K |
| 71045 |
Radiologic examination, chest; single view |
1,682 |
1,247 |
$209K |
| 20610 |
|
2,238 |
800 |
$205K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,931 |
1,528 |
$186K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
5,901 |
4,694 |
$184K |
| 64494 |
|
625 |
290 |
$173K |
| 64483 |
|
400 |
146 |
$157K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,697 |
467 |
$157K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,041 |
2,143 |
$156K |
| 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 |
2,095 |
1,814 |
$139K |
| 36000 |
|
2,474 |
1,753 |
$136K |
| 20553 |
|
1,687 |
681 |
$135K |
| 80053 |
Comprehensive metabolic panel |
22,891 |
15,608 |
$129K |
| 64636 |
|
261 |
81 |
$128K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
629 |
465 |
$128K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,950 |
1,326 |
$117K |
| 36415 |
Collection of venous blood by venipuncture |
48,381 |
30,335 |
$101K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,827 |
2,693 |
$101K |
| 11721 |
|
2,469 |
987 |
$91K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
21,308 |
14,166 |
$91K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
538 |
445 |
$88K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,059 |
1,389 |
$87K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,076 |
844 |
$72K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,664 |
2,316 |
$72K |
| 94760 |
|
953 |
699 |
$63K |
| G0378 |
Hospital observation service, per hour |
312 |
105 |
$63K |
| Q3014 |
Telehealth originating site facility fee |
1,047 |
766 |
$60K |
| 64484 |
|
145 |
61 |
$57K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,007 |
3,464 |
$46K |
| 70450 |
Computed tomography, head or brain; without contrast material |
367 |
282 |
$38K |
| 64490 |
|
75 |
26 |
$37K |
| 90834 |
Psychotherapy, 45 minutes with patient |
429 |
149 |
$36K |
| 87631 |
|
386 |
332 |
$24K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
526 |
403 |
$23K |
| 73630 |
|
990 |
532 |
$22K |
| 71046 |
Radiologic examination, chest; 2 views |
272 |
203 |
$22K |
| 59426 |
|
296 |
125 |
$21K |
| 59425 |
|
278 |
211 |
$20K |
| 84484 |
|
2,765 |
1,560 |
$20K |
| 64491 |
|
36 |
12 |
$17K |
| 29580 |
|
434 |
79 |
$17K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
235 |
105 |
$15K |
| 81001 |
|
7,632 |
5,961 |
$14K |
| 27096 |
|
249 |
154 |
$14K |
| 62323 |
|
28 |
13 |
$13K |
| 80061 |
Lipid panel |
1,542 |
1,351 |
$13K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,293 |
812 |
$12K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
417 |
326 |
$12K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,021 |
1,723 |
$12K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
417 |
326 |
$12K |
| 83605 |
|
1,622 |
1,107 |
$9K |
| 93041 |
|
741 |
539 |
$9K |
| 90832 |
Psychotherapy, 30 minutes with patient |
140 |
53 |
$9K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
221 |
131 |
$9K |
| 81002 |
|
5,462 |
3,972 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
85 |
61 |
$8K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
324 |
250 |
$8K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
709 |
526 |
$8K |
| 76942 |
|
522 |
397 |
$8K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,721 |
1,231 |
$7K |
| 85027 |
|
2,148 |
1,579 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
50 |
38 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
30 |
28 |
$6K |
| 82570 |
|
3,321 |
2,732 |
$6K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
414 |
365 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
79 |
45 |
$6K |
| 83721 |
|
1,522 |
1,344 |
$5K |
| 81003 |
|
2,635 |
1,696 |
$5K |
| 83690 |
|
1,667 |
1,170 |
$5K |
| 81015 |
|
1,719 |
1,036 |
$4K |
| 82150 |
|
1,215 |
869 |
$4K |
| 83986 |
|
3,244 |
2,664 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
918 |
712 |
$4K |
| 87430 |
|
336 |
270 |
$4K |
| 73610 |
|
126 |
78 |
$3K |
| 72100 |
|
1,590 |
990 |
$3K |
| 87428 |
|
85 |
80 |
$3K |
| 87400 |
|
393 |
350 |
$3K |
| 76830 |
Ultrasound, transvaginal |
14 |
12 |
$2K |
| 81025 |
|
945 |
630 |
$2K |
| 84439 |
|
309 |
271 |
$2K |
| 72020 |
|
1,033 |
731 |
$2K |
| 87040 |
|
362 |
135 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13 |
12 |
$2K |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
790 |
425 |
$2K |
| 83880 |
|
61 |
40 |
$2K |
| 99205 |
Prolong outpt/office vis |
18 |
13 |
$2K |
| 85379 |
|
246 |
179 |
$2K |
| 72202 |
|
58 |
38 |
$1K |
| 84702 |
|
155 |
113 |
$1K |
| 87625 |
|
86 |
55 |
$1K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
41 |
26 |
$1K |
| 82947 |
|
1,837 |
1,139 |
$1K |
| 84703 |
|
558 |
370 |
$1K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
15 |
12 |
$1K |
| 83735 |
|
276 |
170 |
$663.37 |
| 87070 |
|
110 |
80 |
$612.13 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
15 |
12 |
$611.60 |
| 86592 |
|
170 |
139 |
$529.09 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
5,075 |
3,276 |
$500.84 |
| 72040 |
|
179 |
118 |
$448.18 |
| 82607 |
|
39 |
37 |
$422.24 |
| 81000 |
|
535 |
329 |
$401.78 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
15 |
12 |
$374.44 |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
19 |
14 |
$362.88 |
| 96127 |
|
240 |
213 |
$342.29 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
302 |
200 |
$341.60 |
| 87280 |
|
25 |
17 |
$301.56 |
| 84144 |
|
16 |
12 |
$256.58 |
| 85610 |
|
100 |
81 |
$255.11 |
| 87660 |
|
15 |
14 |
$234.60 |
| 87480 |
|
15 |
14 |
$234.60 |
| 87510 |
|
15 |
14 |
$234.60 |
| 83970 |
|
14 |
14 |
$222.40 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
268 |
156 |
$215.47 |
| 83540 |
|
47 |
39 |
$213.51 |
| 87420 |
|
16 |
16 |
$206.55 |
| 99000 |
|
24 |
21 |
$155.60 |
| 83550 |
|
28 |
27 |
$148.58 |
| 83655 |
|
12 |
12 |
$145.32 |
| 86308 |
|
34 |
25 |
$138.54 |
| 86160 |
|
15 |
12 |
$123.56 |
| 76000 |
|
18 |
12 |
$108.84 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
170 |
137 |
$98.00 |
| 85730 |
|
21 |
13 |
$96.15 |
| 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 |
38 |
31 |
$74.81 |
| 82043 |
|
56 |
50 |
$69.36 |
| 82950 |
|
15 |
13 |
$52.25 |
| 86901 |
|
46 |
25 |
$50.54 |
| 96160 |
|
105 |
103 |
$45.36 |
| 86850 |
|
28 |
12 |
$41.68 |
| 82962 |
|
102 |
56 |
$37.31 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
931 |
668 |
$35.62 |
| 86900 |
|
28 |
12 |
$23.92 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,138 |
741 |
$13.45 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
17 |
12 |
$9.77 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,635 |
1,091 |
$9.61 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
216 |
163 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
71 |
69 |
$0.00 |
| 99310 |
Prolong nursin fac eval 15m |
33 |
28 |
$0.00 |
| 1090F |
|
172 |
162 |
$0.00 |
| 3078F |
|
180 |
171 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
219 |
123 |
$0.00 |
| 0518F |
|
191 |
181 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
15 |
15 |
$0.00 |
| G0260 |
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
152 |
88 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
88 |
54 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
107 |
98 |
$0.00 |
| 4040F |
|
66 |
64 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
48 |
25 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
25 |
25 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
127 |
123 |
$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 |
53 |
24 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
380 |
264 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
449 |
329 |
$0.00 |
| 1101F |
|
225 |
210 |
$0.00 |
| 3074F |
|
246 |
233 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
267 |
171 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
324 |
219 |
$0.00 |
| 1036F |
|
440 |
418 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
245 |
135 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
18 |
12 |
$0.00 |
| 3008F |
|
259 |
244 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
32 |
29 |
$0.00 |
| A9270 |
Non-covered item or service |
27 |
24 |
$0.00 |
| 1125F |
|
31 |
31 |
$0.00 |
| G9664 |
Patients who are currently statin therapy users or received an order (prescription) for statin therapy |
15 |
15 |
$0.00 |
| 0509F |
|
26 |
25 |
$0.00 |