| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
35,287 |
32,241 |
$7.39M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
36,413 |
33,903 |
$5.10M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
61,164 |
54,555 |
$4.58M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
8,276 |
7,326 |
$3.62M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
10,577 |
9,581 |
$1.08M |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
1,289 |
644 |
$442K |
| S9480 |
Intensive outpatient psychiatric services, per diem |
4,171 |
514 |
$433K |
| J2350 |
Injection, ocrelizumab, 1 mg |
61 |
51 |
$431K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
5,527 |
2,065 |
$355K |
| 59025 |
Fetal non-stress test |
4,026 |
3,152 |
$288K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
368 |
355 |
$261K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
2,497 |
2,364 |
$250K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,761 |
2,601 |
$238K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
513 |
491 |
$220K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
5,215 |
714 |
$205K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,344 |
3,791 |
$144K |
| 71046 |
Radiologic examination, chest; 2 views |
2,587 |
2,326 |
$134K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,731 |
3,812 |
$125K |
| 64615 |
|
566 |
466 |
$92K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
456 |
229 |
$91K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
4,117 |
1,613 |
$77K |
| J2323 |
Injection, natalizumab, 1 mg |
29 |
26 |
$76K |
| G0378 |
Hospital observation service, per hour |
3,485 |
1,738 |
$75K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
100 |
95 |
$61K |
| H0035 |
Mental health partial hospitalization, treatment, less than 24 hours |
558 |
116 |
$59K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
179 |
166 |
$54K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
808 |
607 |
$53K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,487 |
465 |
$45K |
| 71045 |
Radiologic examination, chest; single view |
926 |
797 |
$45K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
64 |
15 |
$39K |
| 95806 |
|
321 |
304 |
$34K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
101 |
93 |
$29K |
| 82947 |
|
1,296 |
344 |
$26K |
| D2750 |
|
32 |
12 |
$22K |
| A0425 |
Ground mileage, per statute mile |
838 |
710 |
$22K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
26 |
26 |
$21K |
| 93296 |
|
1,223 |
1,075 |
$19K |
| 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 |
1,512 |
1,009 |
$16K |
| 95819 |
|
67 |
64 |
$16K |
| D1120 |
Prophylaxis - child |
30 |
28 |
$16K |
| 95716 |
|
16 |
16 |
$14K |
| D1206 |
Topical application of fluoride varnish |
25 |
24 |
$13K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
63 |
58 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
205 |
182 |
$7K |
| 70450 |
Computed tomography, head or brain; without contrast material |
119 |
98 |
$7K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
61 |
51 |
$6K |
| 95800 |
|
43 |
41 |
$6K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
384 |
78 |
$6K |
| 86900 |
|
32 |
26 |
$5K |
| G2066 |
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results |
360 |
300 |
$5K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
568 |
478 |
$5K |
| 95700 |
|
30 |
28 |
$5K |
| 95714 |
|
17 |
12 |
$4K |
| 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 |
83 |
72 |
$4K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
14 |
13 |
$3K |
| 80061 |
Lipid panel |
370 |
335 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
30,168 |
25,580 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
13,683 |
11,508 |
$3K |
| 96116 |
|
16 |
16 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
41,147 |
35,425 |
$3K |
| 94762 |
|
94 |
26 |
$3K |
| 97161 |
|
108 |
89 |
$3K |
| 96415 |
|
61 |
51 |
$2K |
| 90686 |
|
93 |
87 |
$2K |
| 93298 |
|
129 |
116 |
$1K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
14 |
13 |
$1K |
| 81001 |
|
8,894 |
7,894 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
232 |
100 |
$1K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
30 |
12 |
$920.79 |
| J2704 |
Injection, propofol, 10 mg |
1,053 |
734 |
$779.18 |
| 96367 |
|
31 |
26 |
$757.32 |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
12 |
12 |
$681.80 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$566.58 |
| 97165 |
|
30 |
26 |
$550.45 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
22 |
12 |
$542.85 |
| 93017 |
|
13 |
12 |
$529.54 |
| 36415 |
Collection of venous blood by venipuncture |
3,450 |
2,090 |
$470.64 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,961 |
2,596 |
$401.40 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,055 |
4,637 |
$297.83 |
| 84484 |
|
4,668 |
3,573 |
$294.43 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,056 |
1,510 |
$272.25 |
| 81025 |
|
1,956 |
1,848 |
$229.23 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
86 |
70 |
$192.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
40 |
36 |
$181.05 |
| 80053 |
Comprehensive metabolic panel |
3,617 |
3,118 |
$175.66 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
15 |
13 |
$120.85 |
| 84100 |
|
358 |
237 |
$93.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,052 |
607 |
$61.21 |
| 80076 |
|
3,321 |
2,778 |
$55.49 |
| 99152 |
|
598 |
540 |
$54.82 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,509 |
1,417 |
$53.04 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,744 |
1,532 |
$52.14 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
995 |
843 |
$47.30 |
| 83735 |
|
6,153 |
4,529 |
$43.05 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
393 |
366 |
$35.09 |
| 83690 |
|
2,425 |
2,140 |
$34.21 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,181 |
3,848 |
$29.86 |
| 82553 |
|
821 |
565 |
$27.37 |
| 85610 |
|
3,111 |
2,545 |
$19.71 |
| 85027 |
|
209 |
166 |
$18.69 |
| 82550 |
|
1,044 |
709 |
$15.43 |
| 84132 |
|
157 |
116 |
$9.22 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
449 |
243 |
$7.78 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,085 |
1,870 |
$4.21 |
| G0008 |
Administration of influenza virus vaccine |
46 |
41 |
$4.05 |
| J3490 |
Unclassified drugs |
355 |
232 |
$3.54 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,022 |
1,517 |
$1.51 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
58 |
41 |
$0.00 |
| 74019 |
|
242 |
226 |
$0.00 |
| 85730 |
|
1,019 |
900 |
$0.00 |
| 96376 |
|
933 |
336 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
310 |
172 |
$0.00 |
| 83605 |
|
347 |
268 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
975 |
812 |
$0.00 |
| 84703 |
|
135 |
124 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
451 |
379 |
$0.00 |
| 88300 |
|
51 |
50 |
$0.00 |
| 86850 |
|
32 |
26 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
283 |
248 |
$0.00 |
| 88342 |
|
323 |
315 |
$0.00 |
| 87070 |
|
96 |
83 |
$0.00 |
| 86140 |
|
143 |
132 |
$0.00 |
| 99153 |
Mod sedat endo service >5yrs |
29 |
27 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
55 |
37 |
$0.00 |
| 96139 |
|
13 |
12 |
$0.00 |
| 82044 |
|
275 |
253 |
$0.00 |
| 87205 |
|
95 |
82 |
$0.00 |
| 83880 |
|
133 |
118 |
$0.00 |
| 87807 |
|
299 |
279 |
$0.00 |
| 82607 |
|
13 |
12 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
19 |
12 |
$0.00 |
| J3411 |
Injection, thiamine hcl, 100 mg |
105 |
71 |
$0.00 |
| 95886 |
|
17 |
15 |
$0.00 |
| A9270 |
Non-covered item or service |
239 |
87 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
15 |
13 |
$0.00 |
| 83615 |
|
18 |
15 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
163 |
79 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
34 |
31 |
$0.00 |
| 82746 |
|
13 |
12 |
$0.00 |
| 87081 |
|
33 |
31 |
$0.00 |
| 85652 |
|
12 |
12 |
$0.00 |
| 82150 |
|
31 |
28 |
$0.00 |
| 96132 |
|
16 |
16 |
$0.00 |
| 82728 |
|
19 |
16 |
$0.00 |
| 86901 |
|
32 |
26 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
15 |
13 |
$0.00 |
| 81003 |
|
579 |
517 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
112 |
106 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
85 |
62 |
$0.00 |
| 96133 |
|
16 |
16 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
412 |
384 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
180 |
55 |
$0.00 |
| 87210 |
|
116 |
81 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
87 |
72 |
$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 |
87 |
72 |
$0.00 |
| 96138 |
|
12 |
12 |
$0.00 |
| 82140 |
|
73 |
44 |
$0.00 |
| 94664 |
|
44 |
37 |
$0.00 |
| 84145 |
|
109 |
89 |
$0.00 |
| 0100U |
|
17 |
14 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
13 |
12 |
$0.00 |
| 90662 |
|
14 |
12 |
$0.00 |