| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
18,452 |
14,303 |
$827K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,534 |
1,466 |
$103K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,241 |
1,119 |
$77K |
| 0510 |
|
14,896 |
12,263 |
$34K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
763 |
707 |
$31K |
| 0450 |
Emergency room services |
443 |
392 |
$18K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
646 |
633 |
$16K |
| 70450 |
Computed tomography, head or brain; without contrast material |
408 |
398 |
$15K |
| 74174 |
|
531 |
524 |
$14K |
| 0250 |
|
3,169 |
2,293 |
$8K |
| 99199 |
Unlisted special service, procedure or report |
128 |
123 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,247 |
5,693 |
$7K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,176 |
1,117 |
$6K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
220 |
220 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
2,482 |
2,340 |
$6K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
263 |
263 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
851 |
797 |
$5K |
| 80053 |
Comprehensive metabolic panel |
5,623 |
5,124 |
$4K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
12 |
12 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,393 |
2,375 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
549 |
520 |
$3K |
| 88182 |
|
117 |
116 |
$3K |
| 80061 |
Lipid panel |
1,632 |
1,622 |
$2K |
| 90750 |
|
99 |
99 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
740 |
716 |
$2K |
| 80076 |
|
899 |
871 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
241 |
202 |
$2K |
| 76642 |
|
67 |
64 |
$2K |
| 99221 |
|
269 |
230 |
$2K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
272 |
271 |
$2K |
| 92083 |
|
332 |
330 |
$1K |
| 0320 |
|
25 |
23 |
$1K |
| 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 |
74 |
72 |
$1K |
| 71250 |
|
24 |
24 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
257 |
249 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
256 |
248 |
$995.67 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
114 |
84 |
$896.29 |
| 92134 |
|
345 |
341 |
$843.50 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,006 |
992 |
$811.48 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
613 |
416 |
$776.13 |
| 36415 |
Collection of venous blood by venipuncture |
3,576 |
3,119 |
$710.33 |
| 77065 |
Tomosynthesis, mammo |
26 |
26 |
$709.90 |
| 85610 |
|
1,275 |
1,213 |
$680.66 |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
55 |
55 |
$632.86 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
89 |
86 |
$607.84 |
| 81001 |
|
935 |
912 |
$574.34 |
| 84484 |
|
201 |
183 |
$524.25 |
| 83880 |
|
279 |
268 |
$430.24 |
| 83690 |
|
425 |
411 |
$414.52 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
762 |
751 |
$413.56 |
| 99397 |
|
56 |
56 |
$402.56 |
| 85027 |
|
876 |
841 |
$392.26 |
| 92557 |
|
158 |
157 |
$379.16 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
264 |
255 |
$299.78 |
| 93971 |
|
14 |
13 |
$297.92 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
55 |
54 |
$248.24 |
| 86141 |
|
502 |
490 |
$210.84 |
| 0401 |
|
35 |
34 |
$203.13 |
| 84443 |
Thyroid stimulating hormone (TSH) |
225 |
222 |
$201.32 |
| 82728 |
|
227 |
225 |
$199.23 |
| 94726 |
|
57 |
48 |
$195.10 |
| J7050 |
Infusion, normal saline solution, 250 cc |
66 |
52 |
$174.72 |
| 92133 |
|
90 |
90 |
$168.81 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
29 |
29 |
$164.62 |
| 96415 |
|
15 |
12 |
$162.55 |
| 86703 |
|
151 |
151 |
$159.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
480 |
479 |
$155.24 |
| 87088 |
|
36 |
34 |
$148.36 |
| 94729 |
|
42 |
42 |
$147.83 |
| 85730 |
|
217 |
215 |
$134.05 |
| 87536 |
|
18 |
18 |
$122.98 |
| 92250 |
|
32 |
32 |
$120.86 |
| 83550 |
|
333 |
329 |
$115.20 |
| 86593 |
|
175 |
169 |
$114.53 |
| 83540 |
|
353 |
348 |
$109.90 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
37 |
35 |
$103.35 |
| 87522 |
Neg quan hep c or qual rna |
276 |
273 |
$102.87 |
| 86780 |
|
211 |
201 |
$100.59 |
| 86360 |
|
310 |
305 |
$98.05 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
40 |
40 |
$98.01 |
| G0008 |
Administration of influenza virus vaccine |
58 |
58 |
$97.84 |
| 86480 |
|
171 |
171 |
$90.68 |
| 83605 |
|
43 |
43 |
$85.72 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
102 |
102 |
$84.72 |
| 84153 |
|
229 |
224 |
$84.39 |
| 84439 |
|
371 |
363 |
$83.52 |
| 90715 |
|
27 |
25 |
$76.20 |
| 83970 |
|
133 |
131 |
$75.29 |
| 87040 |
|
13 |
13 |
$74.71 |
| 85652 |
|
455 |
446 |
$72.65 |
| 86900 |
|
116 |
105 |
$63.52 |
| 81003 |
|
303 |
299 |
$60.42 |
| 73630 |
|
13 |
13 |
$49.15 |
| 82962 |
|
38 |
38 |
$44.64 |
| 86901 |
|
87 |
78 |
$40.63 |
| 73564 |
|
13 |
12 |
$39.73 |
| 83735 |
|
319 |
297 |
$36.80 |
| 82746 |
|
75 |
75 |
$28.24 |
| 84100 |
|
414 |
398 |
$25.85 |
| 86850 |
|
72 |
65 |
$25.12 |
| 90686 |
|
101 |
100 |
$21.64 |
| 81000 |
|
12 |
12 |
$17.22 |
| 82043 |
|
582 |
579 |
$16.77 |
| 87186 |
|
25 |
25 |
$16.05 |
| 87340 |
|
119 |
107 |
$14.96 |
| 82570 |
|
197 |
185 |
$13.28 |
| 82540 |
|
580 |
577 |
$12.63 |
| 82248 |
|
47 |
46 |
$4.99 |
| 86592 |
|
41 |
40 |
$4.74 |
| 85007 |
|
41 |
27 |
$2.71 |
| 98960 |
|
24 |
19 |
$2.34 |
| 86706 |
|
80 |
80 |
$0.00 |
| 83615 |
|
134 |
124 |
$0.00 |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
50 |
50 |
$0.00 |
| 81015 |
|
13 |
13 |
$0.00 |
| 90677 |
|
104 |
104 |
$0.00 |
| 82105 |
|
14 |
14 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
62 |
62 |
$0.00 |
| 82607 |
|
30 |
30 |
$0.00 |
| 80047 |
|
12 |
12 |
$0.00 |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
14 |
14 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
13 |
$0.00 |
| 84165 |
|
15 |
14 |
$0.00 |
| 77066 |
Tomosynthesis, mammo |
27 |
26 |
$0.00 |
| 90653 |
|
17 |
17 |
$0.00 |
| 86705 |
|
50 |
45 |
$0.00 |
| 85044 |
|
12 |
12 |
$0.00 |
| 94060 |
|
25 |
14 |
$0.00 |
| 82565 |
|
100 |
100 |
$0.00 |
| 92550 |
|
27 |
27 |
$0.00 |
| 92015 |
Determination of refractive state |
56 |
56 |
$0.00 |
| 82274 |
|
13 |
13 |
$0.00 |
| 92591 |
|
13 |
13 |
$0.00 |