| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
32,318 |
31,028 |
$8.28M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
44,807 |
43,318 |
$6.09M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,555 |
4,356 |
$1.77M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
50,882 |
41,519 |
$766K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
1,202 |
1,178 |
$351K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,328 |
14,628 |
$348K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,916 |
16,026 |
$335K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
535 |
529 |
$315K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
728 |
711 |
$296K |
| G0378 |
Hospital observation service, per hour |
5,357 |
4,468 |
$288K |
| 59025 |
Fetal non-stress test |
3,387 |
3,060 |
$280K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,416 |
7,980 |
$238K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
32,691 |
29,439 |
$217K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,101 |
3,041 |
$214K |
| G0379 |
Direct admission of patient for hospital observation care |
4,293 |
4,062 |
$209K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
24,488 |
23,413 |
$165K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
6,486 |
6,193 |
$155K |
| 93325 |
|
1,302 |
1,271 |
$148K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,349 |
2,287 |
$129K |
| 71046 |
Radiologic examination, chest; 2 views |
1,956 |
1,906 |
$126K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,447 |
4,948 |
$120K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,446 |
4,947 |
$120K |
| 93320 |
|
1,191 |
1,167 |
$114K |
| 84443 |
Thyroid stimulating hormone (TSH) |
6,955 |
6,535 |
$114K |
| 71045 |
Radiologic examination, chest; single view |
3,728 |
3,597 |
$112K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,388 |
3,264 |
$104K |
| J3490 |
Unclassified drugs |
87,845 |
46,814 |
$102K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
409 |
278 |
$93K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,839 |
3,615 |
$90K |
| 80053 |
Comprehensive metabolic panel |
11,158 |
9,384 |
$76K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
360 |
354 |
$68K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,291 |
6,865 |
$65K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
6,120 |
5,388 |
$63K |
| 36415 |
Collection of venous blood by venipuncture |
31,379 |
27,507 |
$60K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,372 |
7,075 |
$57K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
609 |
548 |
$57K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
67 |
64 |
$50K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,265 |
1,199 |
$50K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,124 |
2,020 |
$49K |
| 81025 |
|
6,891 |
6,502 |
$47K |
| 88184 |
|
1,737 |
1,472 |
$44K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
823 |
520 |
$43K |
| 81001 |
|
12,404 |
11,850 |
$43K |
| 95819 |
|
234 |
232 |
$40K |
| 85027 |
|
6,686 |
6,137 |
$39K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
86 |
82 |
$37K |
| 84439 |
|
3,832 |
3,678 |
$37K |
| 76801 |
|
791 |
746 |
$36K |
| 94060 |
|
269 |
261 |
$34K |
| 87631 |
|
526 |
513 |
$33K |
| 94760 |
|
2,854 |
2,795 |
$33K |
| 86850 |
|
2,738 |
2,495 |
$31K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
1,293 |
1,184 |
$31K |
| 80061 |
Lipid panel |
2,706 |
2,493 |
$30K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
610 |
593 |
$29K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,595 |
3,296 |
$28K |
| 76770 |
|
195 |
193 |
$27K |
| 88185 |
|
1,737 |
1,472 |
$26K |
| 97802 |
|
447 |
437 |
$25K |
| 99215 |
Prolong outpt/office vis |
798 |
774 |
$23K |
| 70450 |
Computed tomography, head or brain; without contrast material |
162 |
153 |
$23K |
| 86762 |
|
1,525 |
1,427 |
$22K |
| 86592 |
|
5,557 |
5,166 |
$22K |
| 86787 |
|
1,698 |
1,589 |
$22K |
| 80076 |
|
2,810 |
2,687 |
$22K |
| 97803 |
|
437 |
427 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
810 |
778 |
$21K |
| 86800 |
|
1,141 |
1,106 |
$20K |
| 94010 |
|
560 |
550 |
$19K |
| 87536 |
|
1,771 |
1,497 |
$19K |
| 86376 |
|
1,141 |
1,106 |
$17K |
| 83001 |
|
843 |
806 |
$17K |
| 83021 |
|
861 |
808 |
$16K |
| 83002 |
|
839 |
803 |
$16K |
| 84403 |
|
588 |
569 |
$16K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,380 |
1,263 |
$16K |
| 86255 |
|
1,176 |
1,134 |
$15K |
| 83516 |
|
1,201 |
1,159 |
$15K |
| 93225 |
|
90 |
86 |
$14K |
| 87340 |
|
1,537 |
1,430 |
$14K |
| 82670 |
|
539 |
501 |
$14K |
| 80306 |
|
911 |
783 |
$14K |
| 87081 |
|
2,209 |
2,103 |
$13K |
| 83655 |
|
1,074 |
997 |
$13K |
| 83690 |
|
2,063 |
1,972 |
$12K |
| 82784 |
|
1,177 |
1,135 |
$12K |
| 81243 |
|
406 |
276 |
$10K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
331 |
328 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
924 |
896 |
$9K |
| 82533 |
|
435 |
416 |
$8K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
300 |
298 |
$8K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
264 |
135 |
$7K |
| 86703 |
|
551 |
521 |
$7K |
| 82950 |
|
1,554 |
1,468 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
450 |
423 |
$7K |
| 87503 |
|
703 |
683 |
$7K |
| 81003 |
|
2,753 |
2,616 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
509 |
496 |
$7K |
| 90715 |
|
1,406 |
1,345 |
$6K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
26 |
26 |
$5K |
| 86803 |
|
366 |
331 |
$5K |
| J1439 |
Injection, ferric carboxymaltose, 1 mg |
42 |
38 |
$5K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
118 |
115 |
$5K |
| J2704 |
Injection, propofol, 10 mg |
1,244 |
1,218 |
$5K |
| 85660 |
|
861 |
808 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
201 |
198 |
$5K |
| 83520 |
|
349 |
341 |
$5K |
| 84305 |
|
328 |
321 |
$5K |
| 82657 |
|
231 |
226 |
$5K |
| 90686 |
|
3,813 |
3,587 |
$4K |
| J1756 |
Injection, iron sucrose, 1 mg |
24 |
13 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
296 |
268 |
$4K |
| 83525 |
|
275 |
264 |
$3K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
12 |
12 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$3K |
| 83540 |
|
478 |
451 |
$3K |
| 94761 |
|
132 |
97 |
$3K |
| 84484 |
|
433 |
394 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
73 |
66 |
$3K |
| 82728 |
|
178 |
173 |
$3K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
58 |
51 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
141 |
135 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,560 |
1,508 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
17 |
17 |
$2K |
| 84445 |
|
36 |
36 |
$2K |
| 86900 |
|
775 |
668 |
$2K |
| 86901 |
|
775 |
668 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
90 |
83 |
$2K |
| 88342 |
|
42 |
41 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
40 |
27 |
$2K |
| 77336 |
|
29 |
12 |
$2K |
| 76830 |
Ultrasound, transvaginal |
16 |
16 |
$2K |
| 86003 |
|
13 |
12 |
$2K |
| 85652 |
|
572 |
534 |
$2K |
| 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 |
29 |
25 |
$2K |
| 86140 |
|
286 |
266 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
74 |
71 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
25 |
14 |
$1K |
| 83735 |
|
206 |
199 |
$1K |
| 99205 |
Prolong outpt/office vis |
32 |
31 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
922 |
886 |
$1K |
| 85049 |
|
209 |
186 |
$946.98 |
| 95012 |
|
54 |
49 |
$705.44 |
| 85045 |
|
176 |
164 |
$702.85 |
| 85018 |
|
298 |
268 |
$689.15 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
454 |
449 |
$684.10 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
66 |
65 |
$682.35 |
| 85014 |
|
275 |
248 |
$636.05 |
| 84156 |
|
162 |
152 |
$617.90 |
| 82570 |
|
141 |
133 |
$613.34 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
215 |
212 |
$569.72 |
| 83550 |
|
57 |
54 |
$504.18 |
| 84702 |
|
51 |
43 |
$468.70 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
103 |
91 |
$464.88 |
| 82565 |
|
58 |
52 |
$418.26 |
| 82043 |
|
87 |
82 |
$415.29 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
26 |
24 |
$409.41 |
| 87486 |
|
12 |
12 |
$385.08 |
| 87581 |
|
12 |
12 |
$385.08 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
243 |
232 |
$304.43 |
| 83615 |
|
177 |
158 |
$270.46 |
| 90670 |
|
148 |
144 |
$215.71 |
| 84480 |
|
12 |
12 |
$212.04 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
183 |
177 |
$170.11 |
| 82248 |
|
45 |
42 |
$166.00 |
| 81050 |
|
25 |
25 |
$95.72 |
| 83880 |
|
12 |
12 |
$88.84 |
| 90474 |
|
15 |
15 |
$83.58 |
| 82962 |
|
12 |
12 |
$17.52 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
340 |
175 |
$17.40 |
| 84550 |
|
181 |
159 |
$13.16 |
| G0008 |
Administration of influenza virus vaccine |
152 |
128 |
$6.50 |
| 84450 |
|
59 |
53 |
$0.00 |
| 81401 |
|
60 |
58 |
$0.00 |
| 90681 |
|
27 |
27 |
$0.00 |
| 82642 |
|
315 |
199 |
$0.00 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
182 |
171 |
$0.00 |
| 90647 |
|
63 |
62 |
$0.00 |
| 90723 |
|
41 |
41 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
22 |
13 |
$0.00 |