| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
6,535 |
6,286 |
$879K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
4,343 |
4,018 |
$786K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
5,510 |
4,998 |
$753K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
12,331 |
11,129 |
$628K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
4,133 |
3,738 |
$291K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,858 |
2,523 |
$192K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,401 |
1,353 |
$163K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,747 |
2,353 |
$101K |
| G0378 |
Hospital observation service, per hour |
156 |
89 |
$69K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
672 |
651 |
$57K |
| 71046 |
Radiologic examination, chest; 2 views |
2,326 |
2,193 |
$50K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,389 |
572 |
$46K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
835 |
832 |
$41K |
| 70450 |
Computed tomography, head or brain; without contrast material |
878 |
840 |
$40K |
| 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 |
807 |
789 |
$39K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,183 |
1,922 |
$36K |
| 76830 |
Ultrasound, transvaginal |
736 |
695 |
$35K |
| 71045 |
Radiologic examination, chest; single view |
1,326 |
1,272 |
$28K |
| 82947 |
|
2,633 |
2,315 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
950 |
931 |
$25K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
284 |
259 |
$22K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
270 |
254 |
$21K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,339 |
1,307 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
364 |
354 |
$19K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
680 |
678 |
$18K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
328 |
296 |
$17K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
619 |
618 |
$17K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
405 |
333 |
$16K |
| 99406 |
|
763 |
728 |
$11K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
832 |
828 |
$10K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
130 |
126 |
$8K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
595 |
588 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
10,153 |
8,783 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
105 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
117 |
112 |
$6K |
| 80053 |
Comprehensive metabolic panel |
2,864 |
2,612 |
$5K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,460 |
3,229 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
443 |
115 |
$5K |
| 86900 |
|
694 |
650 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,909 |
4,354 |
$4K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
730 |
656 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
219 |
215 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
214 |
210 |
$3K |
| 84484 |
|
1,943 |
1,667 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
544 |
530 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
138 |
130 |
$3K |
| 80061 |
Lipid panel |
252 |
251 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
63 |
61 |
$3K |
| 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 |
359 |
353 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
84 |
84 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
201 |
201 |
$2K |
| 73564 |
|
50 |
49 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
54 |
52 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
5,025 |
4,488 |
$2K |
| 83735 |
|
3,175 |
2,864 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
123 |
123 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
18 |
15 |
$2K |
| A9270 |
Non-covered item or service |
4,525 |
3,864 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13 |
13 |
$2K |
| 87390 |
|
188 |
187 |
$2K |
| 73030 |
|
63 |
55 |
$1K |
| 81025 |
|
3,769 |
3,500 |
$1K |
| 84702 |
|
453 |
387 |
$1K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
19 |
18 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
826 |
781 |
$1K |
| 73610 |
|
109 |
104 |
$1K |
| 86702 |
|
188 |
187 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
631 |
612 |
$998.10 |
| 73630 |
|
132 |
127 |
$979.45 |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
13 |
13 |
$767.72 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
181 |
179 |
$753.86 |
| 59025 |
Fetal non-stress test |
16 |
12 |
$752.55 |
| 84439 |
|
190 |
186 |
$704.53 |
| 90656 |
|
40 |
38 |
$704.43 |
| 86701 |
|
188 |
187 |
$675.70 |
| 86803 |
|
116 |
116 |
$669.05 |
| 97162 |
|
14 |
13 |
$632.31 |
| 87660 |
|
64 |
63 |
$600.66 |
| 87510 |
|
64 |
63 |
$600.65 |
| 87480 |
|
64 |
63 |
$600.65 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
407 |
391 |
$587.51 |
| 87340 |
|
143 |
143 |
$578.32 |
| 86762 |
|
103 |
103 |
$540.04 |
| 82565 |
|
1,636 |
1,520 |
$519.21 |
| 86850 |
|
546 |
511 |
$493.25 |
| 85610 |
|
2,395 |
2,171 |
$423.33 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
653 |
497 |
$415.87 |
| 84460 |
|
580 |
550 |
$407.13 |
| 81002 |
|
286 |
263 |
$403.72 |
| 84520 |
|
1,622 |
1,507 |
$393.85 |
| 84480 |
|
54 |
54 |
$392.87 |
| 84450 |
|
569 |
539 |
$390.20 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
17 |
14 |
$353.64 |
| 84402 |
|
28 |
28 |
$348.10 |
| 86592 |
|
175 |
175 |
$340.14 |
| 73110 |
|
13 |
13 |
$314.58 |
| 81001 |
|
4,198 |
3,852 |
$307.01 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$302.10 |
| 84403 |
|
31 |
31 |
$291.12 |
| 87428 |
|
16 |
16 |
$289.60 |
| 90686 |
|
33 |
32 |
$278.87 |
| 73080 |
|
12 |
12 |
$269.64 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
23 |
12 |
$257.34 |
| 87081 |
|
76 |
75 |
$206.10 |
| 80076 |
|
1,270 |
1,187 |
$194.26 |
| Q3014 |
Telehealth originating site facility fee |
13 |
13 |
$192.14 |
| 83001 |
|
25 |
25 |
$190.40 |
| 86901 |
|
681 |
637 |
$187.41 |
| 85730 |
|
2,193 |
2,046 |
$178.63 |
| 81003 |
|
1,075 |
1,025 |
$177.25 |
| 85027 |
|
126 |
110 |
$169.84 |
| 87088 |
|
69 |
65 |
$168.90 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
117 |
112 |
$158.01 |
| 86696 |
|
12 |
12 |
$138.44 |
| 84144 |
|
12 |
12 |
$137.34 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
25 |
25 |
$131.53 |
| 83690 |
|
2,725 |
2,396 |
$125.01 |
| 73130 |
|
26 |
25 |
$124.27 |
| 86787 |
|
27 |
26 |
$119.34 |
| 80305 |
|
515 |
493 |
$117.51 |
| 87186 |
|
46 |
44 |
$112.15 |
| 82570 |
|
49 |
46 |
$110.81 |
| 86695 |
|
12 |
12 |
$94.28 |
| 82247 |
|
225 |
210 |
$85.04 |
| 83002 |
|
12 |
12 |
$81.30 |
| 80051 |
|
1,368 |
1,303 |
$77.34 |
| 82043 |
|
15 |
15 |
$44.57 |
| 83605 |
|
1,237 |
1,108 |
$40.52 |
| 82077 |
|
572 |
529 |
$39.54 |
| 87077 |
|
12 |
12 |
$37.25 |
| 83540 |
|
24 |
24 |
$36.76 |
| 83550 |
|
12 |
12 |
$25.60 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,868 |
2,545 |
$14.84 |
| 87210 |
|
39 |
38 |
$5.92 |
| 82550 |
|
26 |
25 |
$4.76 |
| 84075 |
|
136 |
128 |
$3.03 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,109 |
2,826 |
$2.94 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
808 |
750 |
$0.80 |
| J3490 |
Unclassified drugs |
1,840 |
1,696 |
$0.01 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,839 |
1,766 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
138 |
137 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
783 |
622 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
101 |
97 |
$0.00 |
| 94799 |
|
92 |
84 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
13 |
13 |
$0.00 |
| 90715 |
|
69 |
69 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
30 |
27 |
$0.00 |
| 90670 |
|
62 |
62 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
595 |
584 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
616 |
604 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
417 |
400 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
668 |
634 |
$0.00 |
| 85379 |
|
25 |
25 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
102 |
101 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
25 |
24 |
$0.00 |
| 74022 |
|
39 |
37 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
27 |
25 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
123 |
100 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
41 |
37 |
$0.00 |
| 94760 |
|
13 |
13 |
$0.00 |
| 90698 |
|
25 |
25 |
$0.00 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
24 |
23 |
$0.00 |
| 94761 |
|
13 |
13 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
13 |
12 |
$0.00 |