| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
19,125 |
14,974 |
$1.32M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
14,172 |
10,658 |
$1.32M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
4,270 |
3,266 |
$763K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
13,497 |
11,554 |
$616K |
| G0378 |
Hospital observation service, per hour |
8,273 |
4,111 |
$462K |
| 70450 |
Computed tomography, head or brain; without contrast material |
4,554 |
3,458 |
$251K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
1,230 |
939 |
$227K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
15,401 |
11,039 |
$199K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,823 |
1,386 |
$193K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,155 |
4,760 |
$148K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
426 |
285 |
$128K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
12,495 |
8,576 |
$123K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
7,957 |
5,546 |
$111K |
| 80053 |
Comprehensive metabolic panel |
30,070 |
20,633 |
$106K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34,388 |
22,540 |
$89K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
1,247 |
812 |
$79K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,439 |
2,154 |
$78K |
| 96376 |
|
4,950 |
2,892 |
$75K |
| 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 |
1,786 |
1,445 |
$73K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
924 |
755 |
$71K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,112 |
470 |
$67K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,583 |
2,481 |
$64K |
| 71045 |
Radiologic examination, chest; single view |
13,153 |
9,487 |
$63K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,639 |
4,697 |
$61K |
| 83880 |
|
6,536 |
4,606 |
$58K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17,007 |
12,055 |
$56K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
3,868 |
3,311 |
$49K |
| 84484 |
|
13,254 |
8,951 |
$49K |
| 99070 |
|
5,287 |
2,674 |
$48K |
| J3490 |
Unclassified drugs |
19,885 |
6,676 |
$47K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
924 |
731 |
$41K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
4,644 |
3,205 |
$41K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
19,868 |
11,864 |
$38K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,147 |
1,585 |
$36K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
620 |
511 |
$35K |
| 71046 |
Radiologic examination, chest; 2 views |
3,595 |
2,753 |
$32K |
| 84703 |
|
10,849 |
8,297 |
$31K |
| J2785 |
Injection, regadenoson, 0.1 mg |
441 |
284 |
$31K |
| 83690 |
|
11,138 |
8,129 |
$27K |
| 87040 |
|
3,471 |
2,545 |
$26K |
| 0450 |
Emergency room services |
522 |
454 |
$24K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
117 |
81 |
$20K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
149 |
118 |
$19K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
10,243 |
5,315 |
$19K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
429 |
286 |
$18K |
| 83605 |
|
4,984 |
3,594 |
$18K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,495 |
5,619 |
$18K |
| 76801 |
|
288 |
225 |
$16K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
439 |
348 |
$16K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
1,011 |
800 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
24,600 |
14,578 |
$16K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,970 |
1,401 |
$15K |
| 83735 |
|
7,818 |
4,207 |
$14K |
| 93971 |
|
358 |
278 |
$14K |
| 59025 |
Fetal non-stress test |
499 |
336 |
$14K |
| 76830 |
Ultrasound, transvaginal |
200 |
159 |
$13K |
| 97161 |
|
1,265 |
719 |
$13K |
| 74022 |
|
562 |
415 |
$12K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
5,735 |
2,668 |
$12K |
| 85379 |
|
3,104 |
2,389 |
$12K |
| 85610 |
|
10,997 |
7,356 |
$11K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
679 |
480 |
$11K |
| 81001 |
|
10,639 |
8,121 |
$11K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,417 |
1,759 |
$11K |
| 85730 |
|
7,335 |
5,015 |
$11K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,639 |
2,821 |
$11K |
| 82550 |
|
5,057 |
3,653 |
$10K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
515 |
475 |
$9K |
| 72131 |
|
87 |
78 |
$9K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
409 |
296 |
$9K |
| 87088 |
|
2,820 |
2,194 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
343 |
174 |
$7K |
| 85027 |
|
4,281 |
2,728 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
363 |
330 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
363 |
330 |
$7K |
| 84702 |
|
965 |
766 |
$7K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,297 |
3,186 |
$6K |
| J1815 |
Injection, insulin, per 5 units |
2,449 |
749 |
$6K |
| 81025 |
|
2,499 |
2,030 |
$6K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13,761 |
8,096 |
$5K |
| 97165 |
|
492 |
274 |
$5K |
| 84100 |
|
3,724 |
2,081 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,900 |
1,609 |
$5K |
| 93017 |
|
429 |
287 |
$4K |
| 81003 |
|
5,336 |
4,086 |
$4K |
| 93970 |
|
68 |
41 |
$4K |
| 82962 |
|
5,884 |
2,621 |
$4K |
| 80061 |
Lipid panel |
1,255 |
870 |
$4K |
| 87077 |
|
1,328 |
1,009 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,714 |
1,105 |
$3K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
4,598 |
2,608 |
$3K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
1,200 |
417 |
$3K |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
399 |
283 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
56 |
41 |
$3K |
| 73030 |
|
219 |
187 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
402 |
324 |
$2K |
| 86901 |
|
2,557 |
1,753 |
$2K |
| 86703 |
|
328 |
302 |
$2K |
| J2060 |
Injection, lorazepam, 2 mg |
3,065 |
1,918 |
$2K |
| 73630 |
|
128 |
119 |
$2K |
| 87070 |
|
318 |
241 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,350 |
2,176 |
$2K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
332 |
137 |
$2K |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
394 |
216 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
916 |
514 |
$2K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
1,797 |
1,154 |
$2K |
| J1644 |
Injection, heparin sodium, per 1000 units |
2,108 |
618 |
$2K |
| 73610 |
|
72 |
64 |
$1K |
| 90715 |
|
45 |
40 |
$1K |
| 74018 |
|
125 |
98 |
$1K |
| 80320 |
|
1,524 |
1,264 |
$1K |
| 86850 |
|
1,787 |
1,135 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
104 |
91 |
$1K |
| 87081 |
|
470 |
374 |
$1K |
| 86900 |
|
1,798 |
1,153 |
$1K |
| 82805 |
|
132 |
87 |
$1K |
| 73130 |
|
67 |
54 |
$1K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
107 |
48 |
$1K |
| J0360 |
Injection, hydralazine hcl, up to 20 mg |
323 |
153 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
2,997 |
1,800 |
$965.55 |
| 73564 |
|
51 |
46 |
$947.81 |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
17 |
12 |
$945.36 |
| 86140 |
|
609 |
422 |
$945.02 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,618 |
2,125 |
$920.90 |
| 94644 |
|
79 |
55 |
$894.57 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
267 |
158 |
$861.95 |
| 85007 |
|
979 |
634 |
$860.96 |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
17 |
13 |
$645.86 |
| 86592 |
|
325 |
299 |
$634.23 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,086 |
549 |
$622.51 |
| 87631 |
|
303 |
244 |
$589.61 |
| 84145 |
|
66 |
44 |
$562.23 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
148 |
120 |
$554.63 |
| 82728 |
|
144 |
80 |
$451.64 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
303 |
196 |
$443.64 |
| 87205 |
|
494 |
363 |
$438.10 |
| 84439 |
|
185 |
122 |
$412.56 |
| J1630 |
Injection, haloperidol, up to 5 mg |
253 |
164 |
$401.77 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
88 |
25 |
$369.24 |
| 97162 |
|
26 |
12 |
$352.75 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
251 |
157 |
$337.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
257 |
176 |
$334.80 |
| 80329 |
|
365 |
252 |
$298.05 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,624 |
927 |
$269.47 |
| G0379 |
Direct admission of patient for hospital observation care |
494 |
347 |
$267.35 |
| 85652 |
|
304 |
227 |
$265.91 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
285 |
164 |
$254.98 |
| C9113 |
Injection, pantoprazole sodium, per vial |
617 |
215 |
$199.89 |
| J1790 |
Injection, droperidol, up to 5 mg |
47 |
36 |
$194.81 |
| 80069 |
|
314 |
123 |
$172.90 |
| 87210 |
|
75 |
65 |
$143.86 |
| 83615 |
|
70 |
46 |
$130.04 |
| 82010 |
|
33 |
27 |
$117.18 |
| 86735 |
|
13 |
12 |
$105.02 |
| 87807 |
|
12 |
12 |
$99.80 |
| 64488 |
|
60 |
41 |
$73.92 |
| 82140 |
|
15 |
12 |
$59.64 |
| 99153 |
Mod sedat endo service >5yrs |
35 |
12 |
$56.55 |
| 90658 |
|
14 |
14 |
$54.60 |
| 99152 |
|
35 |
12 |
$45.37 |
| A9270 |
Non-covered item or service |
6,508 |
2,478 |
$43.37 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
18 |
15 |
$29.96 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
40 |
31 |
$29.93 |
| 82553 |
|
19 |
12 |
$23.64 |
| 88304 |
|
20 |
14 |
$20.20 |
| J3480 |
Injection, potassium chloride, per 2 meq |
23 |
12 |
$17.42 |
| 84132 |
|
24 |
12 |
$12.56 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
34 |
19 |
$2.00 |
| 00731 |
|
80 |
69 |
$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 |
91 |
66 |
$0.00 |
| 88312 |
|
18 |
12 |
$0.00 |
| G8978 |
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals |
90 |
65 |
$0.00 |
| S2900 |
Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure) |
145 |
92 |
$0.00 |
| C9399 |
Unclassified drugs or biologicals |
46 |
17 |
$0.00 |
| G8987 |
Self care functional limitation, current status, at therapy episode outset and at reporting intervals |
58 |
39 |
$0.00 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
49 |
12 |
$0.00 |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
39 |
27 |
$0.00 |
| G8980 |
Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting |
13 |
12 |
$0.00 |