| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,785 |
1,713 |
$35K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,554 |
3,477 |
$30K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,789 |
1,717 |
$26K |
| 80053 |
Comprehensive metabolic panel |
4,016 |
3,829 |
$22K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
193 |
187 |
$21K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
79 |
65 |
$21K |
| 80061 |
Lipid panel |
3,121 |
3,070 |
$20K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
130 |
126 |
$16K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
215 |
206 |
$15K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,307 |
3,142 |
$13K |
| 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 |
207 |
195 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,541 |
2,482 |
$11K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,234 |
2,124 |
$11K |
| 86803 |
|
1,517 |
1,484 |
$9K |
| 36415 |
Collection of venous blood by venipuncture |
3,868 |
3,316 |
$9K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,227 |
1,200 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
59 |
58 |
$9K |
| 86780 |
|
1,297 |
1,264 |
$8K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
787 |
774 |
$8K |
| 82607 |
|
873 |
855 |
$8K |
| 82728 |
|
814 |
797 |
$6K |
| 85027 |
|
1,896 |
1,808 |
$6K |
| 87480 |
|
810 |
785 |
$6K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
92 |
76 |
$5K |
| 87660 |
|
818 |
792 |
$5K |
| 80050 |
General health panel |
149 |
138 |
$5K |
| 84439 |
|
711 |
684 |
$5K |
| 87081 |
|
946 |
929 |
$5K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
93 |
91 |
$5K |
| 86870 |
|
110 |
109 |
$5K |
| 87340 |
|
855 |
836 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
26 |
25 |
$4K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
64 |
61 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
216 |
216 |
$4K |
| 87510 |
|
810 |
785 |
$4K |
| 86762 |
|
475 |
463 |
$4K |
| 59025 |
Fetal non-stress test |
31 |
29 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
744 |
663 |
$3K |
| 86850 |
|
810 |
743 |
$3K |
| 82746 |
|
426 |
418 |
$3K |
| 83550 |
|
582 |
573 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
24 |
24 |
$3K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
18 |
18 |
$3K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
34 |
33 |
$3K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$2K |
| 83540 |
|
610 |
601 |
$2K |
| 87186 |
|
459 |
437 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
26 |
26 |
$2K |
| 76830 |
Ultrasound, transvaginal |
20 |
20 |
$1K |
| 82105 |
|
170 |
165 |
$1K |
| 82570 |
|
443 |
426 |
$1K |
| 86140 |
|
301 |
293 |
$1K |
| 82950 |
|
339 |
332 |
$1K |
| 86787 |
|
242 |
236 |
$1K |
| 84702 |
|
199 |
137 |
$1K |
| 82043 |
|
336 |
330 |
$1K |
| 84153 |
|
132 |
130 |
$1K |
| 76642 |
|
14 |
14 |
$998.21 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
16 |
16 |
$965.52 |
| 71046 |
Radiologic examination, chest; 2 views |
45 |
45 |
$847.23 |
| 83880 |
|
56 |
54 |
$765.04 |
| 86900 |
|
510 |
493 |
$752.15 |
| 87070 |
|
103 |
96 |
$743.93 |
| 86901 |
|
511 |
494 |
$740.97 |
| 81001 |
|
490 |
455 |
$640.84 |
| 87147 |
|
186 |
175 |
$628.82 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
18 |
18 |
$612.06 |
| 93971 |
|
12 |
12 |
$579.62 |
| 86703 |
|
39 |
39 |
$562.50 |
| 82947 |
|
208 |
197 |
$550.88 |
| 86706 |
|
90 |
90 |
$487.82 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
152 |
130 |
$476.93 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
12 |
12 |
$427.73 |
| 85652 |
|
205 |
197 |
$412.50 |
| 92558 |
|
19 |
19 |
$401.55 |
| 73610 |
|
16 |
16 |
$314.00 |
| 80076 |
|
55 |
51 |
$311.13 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
18 |
18 |
$306.11 |
| 86038 |
|
39 |
37 |
$293.74 |
| 86696 |
|
13 |
12 |
$273.55 |
| 87205 |
|
74 |
68 |
$267.13 |
| 83735 |
|
117 |
104 |
$228.17 |
| 86695 |
|
13 |
12 |
$186.42 |
| 87088 |
|
53 |
49 |
$183.38 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
113 |
107 |
$173.06 |
| 73630 |
|
14 |
13 |
$166.49 |
| 82670 |
|
12 |
12 |
$155.69 |
| 83690 |
|
169 |
164 |
$138.20 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
14 |
14 |
$124.79 |
| 80069 |
|
30 |
29 |
$124.25 |
| 84481 |
|
14 |
13 |
$106.73 |
| 83001 |
|
12 |
12 |
$95.86 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
128 |
112 |
$93.13 |
| 73030 |
|
14 |
14 |
$78.72 |
| 88720 |
|
18 |
18 |
$66.95 |
| 82565 |
|
12 |
12 |
$58.65 |
| 84550 |
|
26 |
25 |
$47.09 |
| 85610 |
|
140 |
61 |
$40.15 |
| 71045 |
Radiologic examination, chest; single view |
76 |
75 |
$38.88 |
| 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 |
45 |
44 |
$21.98 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
36 |
30 |
$9.12 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
353 |
158 |
$8.80 |
| 84484 |
|
130 |
84 |
$8.36 |
| 84703 |
|
88 |
83 |
$7.30 |
| 81003 |
|
48 |
47 |
$4.07 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
38 |
33 |
$0.84 |
| 85014 |
|
49 |
44 |
$0.00 |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
29 |
29 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
15 |
14 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
146 |
121 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
25 |
18 |
$0.00 |
| 80047 |
|
40 |
40 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
38 |
29 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
24 |
19 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
15 |
14 |
$0.00 |
| 76801 |
|
15 |
13 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
70 |
56 |
$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 |
205 |
193 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
71 |
56 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
35 |
35 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
66 |
55 |
$0.00 |
| A9270 |
Non-covered item or service |
18 |
13 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
29 |
12 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
29 |
28 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
93 |
78 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$0.00 |
| 83605 |
|
32 |
29 |
$0.00 |
| 96376 |
|
46 |
31 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
43 |
43 |
$0.00 |
| 82803 |
|
15 |
14 |
$0.00 |