| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
3,156 |
2,536 |
$507K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,410 |
1,907 |
$439K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,064 |
2,495 |
$424K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
776 |
666 |
$136K |
| G0378 |
Hospital observation service, per hour |
433 |
173 |
$125K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
9,102 |
6,667 |
$90K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
218 |
185 |
$78K |
| 70450 |
Computed tomography, head or brain; without contrast material |
640 |
513 |
$66K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
673 |
546 |
$55K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
217 |
177 |
$55K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,548 |
1,171 |
$52K |
| 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 |
741 |
604 |
$50K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,571 |
726 |
$45K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,942 |
2,294 |
$39K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
912 |
604 |
$35K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,882 |
1,411 |
$35K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,186 |
1,695 |
$29K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,748 |
1,405 |
$28K |
| 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 |
810 |
634 |
$28K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
212 |
152 |
$27K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
711 |
546 |
$27K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,364 |
1,003 |
$26K |
| 80050 |
General health panel |
3,478 |
2,837 |
$25K |
| J3490 |
Unclassified drugs |
5,690 |
1,958 |
$24K |
| 71045 |
Radiologic examination, chest; single view |
1,821 |
1,453 |
$23K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
233 |
207 |
$22K |
| 76830 |
Ultrasound, transvaginal |
265 |
215 |
$20K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
197 |
167 |
$15K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
469 |
338 |
$13K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
307 |
166 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
536 |
472 |
$12K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
536 |
472 |
$12K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
307 |
251 |
$11K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
148 |
118 |
$11K |
| 45384 |
|
16 |
12 |
$11K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
53 |
45 |
$10K |
| 96376 |
|
382 |
231 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
687 |
559 |
$10K |
| 93971 |
|
124 |
109 |
$10K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,447 |
1,153 |
$9K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
13 |
13 |
$9K |
| 84484 |
|
2,295 |
1,511 |
$8K |
| 80061 |
Lipid panel |
943 |
816 |
$8K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,330 |
1,185 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
865 |
606 |
$7K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
34 |
28 |
$7K |
| 97161 |
|
131 |
108 |
$7K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
50 |
41 |
$7K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
644 |
165 |
$6K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
120 |
101 |
$6K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
271 |
223 |
$6K |
| 80053 |
Comprehensive metabolic panel |
3,792 |
2,947 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,220 |
3,100 |
$6K |
| J2704 |
Injection, propofol, 10 mg |
687 |
481 |
$5K |
| 83690 |
|
1,459 |
1,174 |
$5K |
| 97162 |
|
136 |
105 |
$5K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
313 |
94 |
$5K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
234 |
193 |
$5K |
| 94060 |
|
108 |
89 |
$5K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,536 |
1,226 |
$5K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
600 |
410 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
979 |
850 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
545 |
380 |
$4K |
| 83880 |
|
224 |
190 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
673 |
568 |
$4K |
| 97035 |
|
437 |
137 |
$4K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
179 |
153 |
$4K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
152 |
111 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
544 |
234 |
$4K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
56 |
50 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
813 |
562 |
$3K |
| 82947 |
|
711 |
360 |
$3K |
| 83735 |
|
1,039 |
788 |
$3K |
| 84702 |
|
229 |
170 |
$3K |
| 87077 |
|
581 |
466 |
$3K |
| 87186 |
|
520 |
413 |
$3K |
| 87040 |
|
451 |
207 |
$3K |
| 97803 |
|
198 |
148 |
$3K |
| 82728 |
|
242 |
202 |
$3K |
| 84703 |
|
458 |
380 |
$3K |
| 74018 |
|
129 |
103 |
$2K |
| 83605 |
|
444 |
314 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
91 |
79 |
$2K |
| J7060 |
5% dextrose/water (500 ml = 1 unit) |
308 |
189 |
$2K |
| 81001 |
|
1,474 |
1,166 |
$2K |
| J7050 |
Infusion, normal saline solution, 250 cc |
262 |
172 |
$2K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
275 |
156 |
$2K |
| 81025 |
|
434 |
342 |
$2K |
| 72100 |
|
91 |
68 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
6,538 |
4,838 |
$2K |
| 85379 |
|
283 |
245 |
$2K |
| 85610 |
|
1,567 |
935 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
231 |
205 |
$2K |
| 86140 |
|
583 |
444 |
$2K |
| 82805 |
|
114 |
83 |
$2K |
| 97165 |
|
34 |
28 |
$2K |
| 86803 |
|
162 |
133 |
$2K |
| 84439 |
|
223 |
199 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
268 |
155 |
$1K |
| 94729 |
|
90 |
74 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,536 |
1,171 |
$1K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
226 |
135 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,391 |
1,021 |
$1K |
| 73630 |
|
58 |
45 |
$1K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
385 |
282 |
$1K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
274 |
203 |
$1K |
| 73610 |
|
57 |
50 |
$1K |
| 94726 |
|
37 |
29 |
$1K |
| 76801 |
|
18 |
13 |
$1K |
| 86850 |
|
129 |
104 |
$979.53 |
| 73130 |
|
51 |
40 |
$968.93 |
| 73030 |
|
29 |
27 |
$938.42 |
| 87081 |
|
196 |
167 |
$927.91 |
| 87088 |
|
313 |
245 |
$921.71 |
| Q3014 |
Telehealth originating site facility fee |
306 |
201 |
$856.04 |
| 81003 |
|
1,402 |
1,170 |
$831.67 |
| 86618 |
|
75 |
60 |
$804.11 |
| 85652 |
|
473 |
352 |
$792.68 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
30 |
26 |
$782.58 |
| 87070 |
|
109 |
89 |
$718.33 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
46 |
16 |
$702.11 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
416 |
298 |
$686.57 |
| 80305 |
|
852 |
708 |
$670.65 |
| 82607 |
|
71 |
59 |
$654.89 |
| J1610 |
Injection, glucagon hydrochloride, per 1 mg |
16 |
13 |
$622.62 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
17 |
13 |
$561.36 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
709 |
500 |
$536.91 |
| 82375 |
|
114 |
83 |
$500.92 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
95 |
64 |
$499.75 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
338 |
240 |
$496.76 |
| 87205 |
|
161 |
132 |
$490.53 |
| 87807 |
|
52 |
42 |
$474.80 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
53 |
38 |
$444.87 |
| 85027 |
|
140 |
124 |
$419.42 |
| 85730 |
|
113 |
91 |
$387.72 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
202 |
163 |
$309.15 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
27 |
$280.08 |
| J2060 |
Injection, lorazepam, 2 mg |
228 |
164 |
$274.95 |
| 83550 |
|
34 |
30 |
$274.37 |
| 84153 |
|
24 |
24 |
$271.50 |
| 96367 |
|
14 |
12 |
$255.83 |
| 36416 |
|
606 |
457 |
$252.11 |
| 86900 |
|
134 |
101 |
$250.00 |
| A9270 |
Non-covered item or service |
1,413 |
670 |
$242.20 |
| 86901 |
|
134 |
101 |
$223.26 |
| 83540 |
|
36 |
32 |
$215.47 |
| 82550 |
|
54 |
47 |
$204.76 |
| 86592 |
|
65 |
55 |
$196.89 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
146 |
113 |
$188.27 |
| 82950 |
|
41 |
38 |
$170.82 |
| 86038 |
|
19 |
13 |
$146.53 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
29 |
25 |
$144.76 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
39 |
32 |
$134.69 |
| J3480 |
Injection, potassium chloride, per 2 meq |
13 |
12 |
$119.25 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
15 |
12 |
$119.09 |
| 84100 |
|
33 |
25 |
$102.22 |
| 87147 |
|
15 |
12 |
$96.46 |
| 51798 |
|
19 |
13 |
$83.59 |
| 82043 |
|
16 |
13 |
$70.11 |
| G0008 |
Administration of influenza virus vaccine |
121 |
101 |
$49.95 |
| 90686 |
|
64 |
54 |
$35.70 |
| 84550 |
|
14 |
12 |
$30.20 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
41 |
38 |
$0.00 |