| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
3,444 |
1,826 |
$334K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,089 |
2,873 |
$203K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,649 |
2,102 |
$155K |
| 58558 |
|
149 |
142 |
$125K |
| J3490 |
Unclassified drugs |
624 |
345 |
$75K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,229 |
1,565 |
$63K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
9,230 |
3,871 |
$27K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,384 |
2,424 |
$22K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
595 |
489 |
$19K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
693 |
541 |
$15K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,149 |
877 |
$11K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
11,510 |
4,666 |
$4K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
157 |
133 |
$3K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
307 |
257 |
$3K |
| 84702 |
|
425 |
353 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
4,955 |
3,207 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,196 |
2,345 |
$2K |
| 80053 |
Comprehensive metabolic panel |
2,093 |
1,272 |
$2K |
| 94762 |
|
1,529 |
1,330 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
4,226 |
2,870 |
$2K |
| 82550 |
|
3,084 |
1,723 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,324 |
1,008 |
$1K |
| 81025 |
|
529 |
460 |
$1K |
| 81001 |
|
3,148 |
2,440 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
778 |
616 |
$1K |
| 82553 |
|
2,347 |
1,412 |
$1K |
| 82962 |
|
1,668 |
598 |
$954.25 |
| Q0222 |
Injection, bebtelovimab, 175 mg |
62 |
42 |
$614.88 |
| 85610 |
|
1,508 |
1,188 |
$542.92 |
| 80076 |
|
1,176 |
936 |
$498.31 |
| 84484 |
|
1,406 |
740 |
$479.69 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
286 |
198 |
$421.40 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,328 |
1,060 |
$417.60 |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
63 |
42 |
$397.40 |
| 85730 |
|
996 |
795 |
$337.33 |
| 93041 |
|
969 |
866 |
$328.12 |
| J2060 |
Injection, lorazepam, 2 mg |
980 |
525 |
$320.98 |
| 87400 |
|
98 |
80 |
$314.66 |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
17 |
13 |
$305.68 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
12 |
12 |
$302.45 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
557 |
434 |
$289.16 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
528 |
455 |
$280.31 |
| 83690 |
|
946 |
774 |
$245.37 |
| 71250 |
|
18 |
13 |
$217.00 |
| 82140 |
|
119 |
67 |
$208.28 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
114 |
102 |
$159.23 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
818 |
343 |
$115.68 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,262 |
948 |
$109.80 |
| 86901 |
|
225 |
174 |
$88.61 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
817 |
670 |
$79.33 |
| 88307 |
|
42 |
38 |
$67.15 |
| J2704 |
Injection, propofol, 10 mg |
805 |
669 |
$51.82 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
32 |
29 |
$50.22 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
184 |
163 |
$46.49 |
| 86850 |
|
183 |
146 |
$41.22 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
229 |
175 |
$33.55 |
| J1630 |
Injection, haloperidol, up to 5 mg |
37 |
25 |
$33.29 |
| 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 |
19 |
16 |
$19.43 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
156 |
76 |
$14.19 |
| 86900 |
|
207 |
162 |
$13.66 |
| 85027 |
|
139 |
103 |
$5.44 |
| 85007 |
|
92 |
65 |
$3.31 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
116 |
93 |
$0.98 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
97 |
77 |
$0.75 |
| J1645 |
Injection, dalteparin sodium, per 2500 iu |
43 |
32 |
$0.66 |
| J7050 |
Infusion, normal saline solution, 250 cc |
27 |
24 |
$0.44 |
| 36000 |
|
66 |
54 |
$0.33 |
| 82150 |
|
311 |
237 |
$0.15 |
| 83615 |
|
41 |
33 |
$0.00 |
| 85379 |
|
51 |
40 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
74 |
60 |
$0.00 |
| 83605 |
|
112 |
82 |
$0.00 |
| 87040 |
|
65 |
52 |
$0.00 |
| Q0247 |
Injection, sotrovimab, 500 mg |
18 |
15 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
37 |
25 |
$0.00 |
| 82607 |
|
17 |
12 |
$0.00 |
| 82746 |
|
17 |
12 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
18 |
13 |
$0.00 |
| 83520 |
|
15 |
13 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
34 |
26 |
$0.00 |
| 82948 |
|
40 |
13 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
16 |
13 |
$0.00 |