| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
4,300 |
3,904 |
$256K |
| 0214 |
|
24 |
24 |
$211K |
| 0121 |
|
23 |
23 |
$182K |
| 0122 |
|
13 |
13 |
$91K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
461 |
437 |
$40K |
| J3490 |
Unclassified drugs |
2,714 |
1,496 |
$33K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
88 |
84 |
$27K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
766 |
709 |
$21K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
304 |
280 |
$19K |
| 70450 |
Computed tomography, head or brain; without contrast material |
138 |
134 |
$18K |
| 80053 |
Comprehensive metabolic panel |
1,384 |
1,258 |
$14K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
145 |
130 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
324 |
300 |
$13K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,608 |
1,425 |
$12K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
86 |
83 |
$10K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
79 |
74 |
$7K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
46 |
45 |
$7K |
| 90715 |
|
95 |
95 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
227 |
225 |
$6K |
| 0510 |
|
167 |
144 |
$6K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
57 |
54 |
$6K |
| 0762 |
|
93 |
47 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
108 |
107 |
$5K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
108 |
107 |
$5K |
| 84484 |
|
507 |
410 |
$5K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
493 |
450 |
$5K |
| 93971 |
|
36 |
34 |
$4K |
| 76801 |
|
44 |
41 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
255 |
246 |
$4K |
| 83690 |
|
492 |
467 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
17 |
17 |
$3K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13 |
13 |
$3K |
| 0360 |
|
40 |
26 |
$3K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
79 |
73 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
110 |
101 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
56 |
52 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
236 |
118 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
43 |
36 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
40 |
40 |
$2K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
18 |
16 |
$2K |
| 82947 |
|
391 |
298 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
265 |
251 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
29 |
29 |
$2K |
| 87040 |
|
173 |
91 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
15 |
15 |
$2K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
22 |
21 |
$2K |
| 83880 |
|
52 |
48 |
$2K |
| 0750 |
|
12 |
12 |
$2K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
259 |
237 |
$2K |
| J0500 |
Injection, dicyclomine hcl, up to 20 mg |
14 |
14 |
$2K |
| 83605 |
|
150 |
122 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
177 |
158 |
$2K |
| 81001 |
|
481 |
458 |
$2K |
| 84703 |
|
188 |
183 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
141 |
138 |
$1K |
| 73562 |
|
49 |
46 |
$1K |
| 84702 |
|
82 |
73 |
$1K |
| 73630 |
|
56 |
55 |
$1K |
| 81025 |
|
295 |
290 |
$1K |
| 83735 |
|
177 |
169 |
$1K |
| 73130 |
|
46 |
44 |
$1K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
110 |
101 |
$1K |
| 76770 |
|
14 |
14 |
$1K |
| 73030 |
|
40 |
38 |
$993.80 |
| 73610 |
|
38 |
36 |
$963.83 |
| 73110 |
|
37 |
35 |
$889.97 |
| 84443 |
Thyroid stimulating hormone (TSH) |
53 |
52 |
$876.01 |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$853.53 |
| 0250 |
|
540 |
459 |
$836.07 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
80 |
74 |
$755.77 |
| 73080 |
|
30 |
28 |
$753.88 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
92 |
90 |
$752.41 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
74 |
67 |
$633.11 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
95 |
95 |
$629.44 |
| 85379 |
|
57 |
56 |
$622.88 |
| 86803 |
|
38 |
38 |
$584.86 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
58 |
53 |
$582.78 |
| 51701 |
|
16 |
16 |
$571.94 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
79 |
71 |
$563.34 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
73 |
65 |
$537.18 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
66 |
60 |
$536.97 |
| 12001 |
|
19 |
18 |
$523.82 |
| 87077 |
|
51 |
46 |
$492.37 |
| 87186 |
|
46 |
40 |
$476.45 |
| 86703 |
|
33 |
33 |
$467.06 |
| 0710 |
|
27 |
27 |
$457.26 |
| 85730 |
|
74 |
72 |
$454.50 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
15 |
15 |
$452.18 |
| J0780 |
Injection, prochlorperazine, up to 10 mg |
19 |
19 |
$450.46 |
| J2060 |
Injection, lorazepam, 2 mg |
57 |
51 |
$441.87 |
| 85610 |
|
114 |
110 |
$439.37 |
| 73140 |
|
30 |
29 |
$420.24 |
| 10060 |
|
16 |
16 |
$413.12 |
| J7050 |
Infusion, normal saline solution, 250 cc |
42 |
36 |
$389.34 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
12 |
12 |
$386.00 |
| 72100 |
|
13 |
12 |
$348.34 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
39 |
39 |
$324.03 |
| 87210 |
|
72 |
72 |
$308.38 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
19 |
14 |
$284.24 |
| 12002 |
|
13 |
13 |
$268.58 |
| 29125 |
|
30 |
29 |
$257.97 |
| J2704 |
Injection, propofol, 10 mg |
24 |
20 |
$257.87 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
19 |
19 |
$244.34 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
18 |
16 |
$192.75 |
| 82550 |
|
27 |
25 |
$166.35 |
| 86901 |
|
54 |
53 |
$156.72 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
15 |
15 |
$151.22 |
| J1630 |
Injection, haloperidol, up to 5 mg |
18 |
17 |
$147.83 |
| 86900 |
|
47 |
42 |
$133.63 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
19 |
19 |
$128.10 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
14 |
13 |
$125.80 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
17 |
16 |
$115.62 |
| 36415 |
Collection of venous blood by venipuncture |
197 |
156 |
$73.33 |
| 82009 |
|
12 |
12 |
$58.29 |
| 81003 |
|
21 |
18 |
$48.22 |
| 86850 |
|
15 |
15 |
$45.93 |
| 0272 |
|
40 |
40 |
$3.67 |
| 0302 |
|
34 |
34 |
$0.00 |
| 0300 |
|
100 |
96 |
$0.00 |
| 0730 |
|
33 |
33 |
$0.00 |
| 0412 |
|
13 |
13 |
$0.00 |
| 0402 |
|
15 |
15 |
$0.00 |
| 0301 |
|
142 |
136 |
$0.00 |
| 0307 |
|
24 |
24 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
68 |
59 |
$0.00 |
| 0306 |
|
77 |
74 |
$0.00 |
| 0255 |
|
17 |
17 |
$0.00 |
| 0305 |
|
146 |
138 |
$0.00 |
| 0258 |
|
82 |
79 |
$0.00 |
| 0370 |
|
22 |
22 |
$0.00 |
| 0324 |
|
31 |
31 |
$0.00 |
| 0352 |
|
13 |
13 |
$0.00 |
| 0171 |
Inj, epinephrine (belcher) |
15 |
15 |
$0.00 |
| 0721 |
|
17 |
17 |
$0.00 |
| 0949 |
|
32 |
32 |
$0.00 |
| 0420 |
|
12 |
12 |
$0.00 |