| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,337 |
3,229 |
$671K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,991 |
4,009 |
$666K |
| 87428 |
|
7,789 |
6,721 |
$428K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,737 |
1,201 |
$303K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
7,904 |
6,585 |
$250K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13,664 |
7,290 |
$220K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15,484 |
13,278 |
$206K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,310 |
1,949 |
$200K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,359 |
2,739 |
$160K |
| 71046 |
Radiologic examination, chest; 2 views |
3,626 |
3,115 |
$144K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,673 |
1,585 |
$134K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,664 |
2,468 |
$110K |
| 74018 |
|
1,921 |
1,672 |
$79K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
811 |
667 |
$75K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,800 |
1,708 |
$54K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
418 |
53 |
$40K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,796 |
1,392 |
$37K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
742 |
576 |
$31K |
| 71045 |
Radiologic examination, chest; single view |
884 |
710 |
$29K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
5,090 |
3,916 |
$27K |
| 80053 |
Comprehensive metabolic panel |
3,264 |
2,580 |
$21K |
| 70450 |
Computed tomography, head or brain; without contrast material |
227 |
187 |
$19K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
416 |
81 |
$16K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
149 |
124 |
$15K |
| 73560 |
|
335 |
293 |
$13K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
387 |
297 |
$12K |
| 81025 |
|
1,790 |
1,590 |
$12K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
396 |
284 |
$11K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
104 |
67 |
$11K |
| 81003 |
|
3,849 |
3,328 |
$8K |
| 81001 |
|
3,153 |
2,759 |
$8K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
931 |
777 |
$8K |
| 80305 |
|
700 |
624 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
3,715 |
2,619 |
$6K |
| 87634 |
|
78 |
76 |
$5K |
| 84484 |
|
727 |
486 |
$4K |
| 72100 |
|
85 |
69 |
$4K |
| 87807 |
|
362 |
321 |
$4K |
| 73630 |
|
81 |
69 |
$3K |
| 87210 |
|
765 |
688 |
$3K |
| 73610 |
|
95 |
68 |
$3K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
14 |
12 |
$2K |
| 73030 |
|
41 |
36 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
14 |
12 |
$1K |
| 82553 |
|
86 |
70 |
$855.11 |
| 83735 |
|
250 |
182 |
$829.13 |
| 73130 |
|
12 |
12 |
$701.57 |
| 82150 |
|
106 |
96 |
$637.43 |
| 83874 |
|
47 |
36 |
$500.84 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
994 |
799 |
$419.48 |
| 83880 |
|
14 |
13 |
$418.06 |
| Q3014 |
Telehealth originating site facility fee |
19 |
18 |
$296.30 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
81 |
66 |
$294.94 |
| 83690 |
|
39 |
36 |
$253.31 |
| 87088 |
|
28 |
28 |
$227.75 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
742 |
586 |
$174.06 |
| 82962 |
|
112 |
64 |
$168.93 |
| 85610 |
|
46 |
39 |
$148.25 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
19 |
17 |
$144.46 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
430 |
356 |
$101.47 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
357 |
276 |
$8.70 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,019 |
674 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
28 |
25 |
$0.00 |
| J3490 |
Unclassified drugs |
1,100 |
767 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
33 |
24 |
$0.00 |