| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
7,381 |
6,777 |
$901K |
| 80053 |
Comprehensive metabolic panel |
5,398 |
5,004 |
$389K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
1,375 |
781 |
$303K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,883 |
4,595 |
$221K |
| Z7502 |
|
5,012 |
4,988 |
$186K |
| J3490 |
Unclassified drugs |
7,138 |
3,569 |
$119K |
| 71046 |
Radiologic examination, chest; 2 views |
1,592 |
1,505 |
$79K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
745 |
726 |
$78K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,072 |
970 |
$77K |
| 87081 |
|
501 |
482 |
$50K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,056 |
1,002 |
$46K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,752 |
2,405 |
$40K |
| 87420 |
|
291 |
280 |
$39K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
280 |
277 |
$38K |
| Z7610 |
|
2,317 |
1,380 |
$28K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
731 |
574 |
$25K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,555 |
1,467 |
$24K |
| 70450 |
Computed tomography, head or brain; without contrast material |
707 |
680 |
$24K |
| 81001 |
|
5,059 |
4,822 |
$23K |
| 36415 |
Collection of venous blood by venipuncture |
1,477 |
1,159 |
$19K |
| 71020 |
|
126 |
125 |
$19K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
7,096 |
6,391 |
$18K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,111 |
838 |
$17K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,068 |
1,922 |
$15K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,461 |
2,741 |
$15K |
| 73610 |
|
139 |
137 |
$14K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
754 |
685 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,351 |
1,301 |
$13K |
| 0710 |
|
536 |
532 |
$13K |
| 73030 |
|
126 |
122 |
$13K |
| 71045 |
Radiologic examination, chest; single view |
875 |
825 |
$12K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,379 |
1,175 |
$12K |
| 0250 |
|
1,143 |
892 |
$12K |
| 73564 |
|
143 |
133 |
$12K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,559 |
1,437 |
$11K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
532 |
521 |
$10K |
| 73630 |
|
162 |
150 |
$10K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,545 |
2,345 |
$10K |
| 84702 |
|
695 |
645 |
$9K |
| Z9725 |
|
201 |
199 |
$9K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
285 |
256 |
$9K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
667 |
219 |
$8K |
| 74018 |
|
87 |
85 |
$7K |
| 80306 |
|
514 |
485 |
$6K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
268 |
251 |
$6K |
| 45378 |
Colonoscopy, flexible; diagnostic, including collection of specimen(s) |
197 |
195 |
$6K |
| 84484 |
|
1,521 |
1,309 |
$5K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
17 |
12 |
$5K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
244 |
236 |
$5K |
| 72100 |
|
85 |
83 |
$5K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
82 |
52 |
$5K |
| 72040 |
|
28 |
27 |
$4K |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
323 |
300 |
$4K |
| 86850 |
|
48 |
48 |
$3K |
| 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 |
423 |
364 |
$3K |
| 83735 |
|
866 |
768 |
$3K |
| 83880 |
|
496 |
463 |
$3K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
487 |
466 |
$3K |
| 0272 |
|
548 |
467 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
252 |
248 |
$3K |
| 84443 |
Thyroid stimulating hormone (TSH) |
268 |
260 |
$3K |
| 81025 |
|
1,838 |
1,719 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
548 |
533 |
$2K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
528 |
524 |
$2K |
| 82962 |
|
693 |
514 |
$2K |
| 82553 |
|
765 |
700 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
60 |
53 |
$2K |
| 96367 |
|
73 |
36 |
$2K |
| 94644 |
|
106 |
101 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,462 |
1,286 |
$2K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
676 |
214 |
$2K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
86 |
85 |
$2K |
| 80061 |
Lipid panel |
67 |
58 |
$2K |
| 87040 |
|
372 |
360 |
$1K |
| 82550 |
|
796 |
727 |
$1K |
| 85730 |
|
983 |
928 |
$1K |
| 87077 |
|
373 |
360 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
411 |
327 |
$1K |
| 76830 |
Ultrasound, transvaginal |
61 |
57 |
$1K |
| 73130 |
|
33 |
30 |
$1K |
| 83690 |
|
1,932 |
1,806 |
$1K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$931.78 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
60 |
59 |
$884.97 |
| 88342 |
|
32 |
31 |
$813.90 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
413 |
303 |
$809.33 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,108 |
1,021 |
$791.47 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
117 |
112 |
$783.66 |
| 85379 |
|
191 |
186 |
$752.11 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
222 |
214 |
$615.75 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
222 |
214 |
$615.07 |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
14 |
14 |
$583.68 |
| 0762 |
|
30 |
29 |
$578.53 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
17 |
12 |
$433.87 |
| 85610 |
|
1,375 |
1,289 |
$430.77 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
474 |
462 |
$420.35 |
| 87186 |
|
335 |
325 |
$416.70 |
| 76801 |
|
48 |
41 |
$416.42 |
| 73502 |
|
12 |
12 |
$401.04 |
| 83605 |
|
405 |
384 |
$346.70 |
| 90715 |
|
116 |
114 |
$345.02 |
| 81003 |
|
573 |
529 |
$328.25 |
| J7050 |
Infusion, normal saline solution, 250 cc |
78 |
45 |
$305.94 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
675 |
572 |
$277.17 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
448 |
404 |
$265.40 |
| 86900 |
|
313 |
299 |
$234.15 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$233.66 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
17 |
15 |
$226.10 |
| 86901 |
|
313 |
299 |
$218.02 |
| 82950 |
|
36 |
36 |
$191.00 |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
12 |
12 |
$145.20 |
| 0270 |
|
539 |
450 |
$92.76 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
115 |
96 |
$87.44 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
12 |
12 |
$86.50 |
| J2060 |
Injection, lorazepam, 2 mg |
169 |
155 |
$31.39 |
| 86140 |
|
92 |
85 |
$31.16 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
12 |
12 |
$29.37 |
| 85027 |
|
29 |
28 |
$26.69 |
| 82150 |
|
37 |
37 |
$26.09 |
| 87210 |
|
44 |
44 |
$10.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
24 |
$8.92 |
| A9270 |
Non-covered item or service |
3,356 |
2,907 |
$3.30 |
| 0258 |
|
35 |
12 |
$3.16 |
| G0378 |
Hospital observation service, per hour |
178 |
150 |
$0.00 |
| 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 |
502 |
473 |
$0.00 |
| 96376 |
|
103 |
74 |
$0.00 |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
12 |
12 |
$0.00 |
| 93971 |
|
15 |
13 |
$0.00 |
| 73110 |
|
13 |
12 |
$0.00 |
| 71010 |
|
13 |
13 |
$0.00 |