| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12,282 |
10,878 |
$1.61M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,449 |
10,518 |
$1.35M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,721 |
2,214 |
$799K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
8,884 |
2,340 |
$664K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,590 |
3,324 |
$353K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,446 |
3,187 |
$333K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,305 |
1,086 |
$321K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,586 |
2,264 |
$296K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
3,565 |
1,056 |
$265K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
2,208 |
1,823 |
$264K |
| 64483 |
|
474 |
434 |
$258K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,395 |
843 |
$225K |
| 70450 |
Computed tomography, head or brain; without contrast material |
985 |
830 |
$218K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,447 |
2,212 |
$214K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
2,565 |
708 |
$212K |
| 80053 |
Comprehensive metabolic panel |
15,833 |
13,427 |
$169K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,707 |
1,586 |
$157K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,751 |
1,344 |
$139K |
| G0378 |
Hospital observation service, per hour |
2,276 |
890 |
$118K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
389 |
335 |
$111K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
442 |
351 |
$99K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
203 |
169 |
$92K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
3,415 |
1,033 |
$81K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
285 |
244 |
$74K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
695 |
416 |
$66K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,559 |
3,149 |
$65K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
22,366 |
17,793 |
$58K |
| 59025 |
Fetal non-stress test |
336 |
238 |
$52K |
| 80061 |
Lipid panel |
3,379 |
3,076 |
$44K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,493 |
1,447 |
$41K |
| 95886 |
|
107 |
103 |
$40K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
172 |
153 |
$39K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
340 |
200 |
$38K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,077 |
3,178 |
$37K |
| 97161 |
|
653 |
586 |
$37K |
| 36415 |
Collection of venous blood by venipuncture |
17,225 |
12,914 |
$36K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,132 |
1,839 |
$31K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,563 |
2,303 |
$30K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
151 |
84 |
$29K |
| 71046 |
Radiologic examination, chest; 2 views |
894 |
813 |
$29K |
| 97162 |
|
580 |
495 |
$28K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
262 |
237 |
$27K |
| 87088 |
|
3,999 |
3,466 |
$26K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,094 |
984 |
$23K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
501 |
465 |
$23K |
| 64493 |
|
29 |
26 |
$22K |
| 97597 |
|
231 |
146 |
$22K |
| 74018 |
|
397 |
345 |
$19K |
| 82607 |
|
1,115 |
978 |
$19K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
524 |
476 |
$18K |
| 82728 |
|
1,301 |
1,188 |
$18K |
| 85027 |
|
1,987 |
1,694 |
$17K |
| 84439 |
|
798 |
701 |
$15K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
701 |
624 |
$13K |
| 80051 |
|
620 |
445 |
$12K |
| 84484 |
|
4,955 |
3,481 |
$12K |
| 87077 |
|
1,297 |
979 |
$11K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
7,128 |
5,496 |
$10K |
| 87653 |
|
188 |
177 |
$10K |
| 86803 |
|
553 |
492 |
$10K |
| 86703 |
|
390 |
335 |
$10K |
| 45385 |
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) |
12 |
12 |
$10K |
| 83540 |
|
1,153 |
1,052 |
$10K |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
453 |
428 |
$10K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
524 |
476 |
$9K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
250 |
80 |
$9K |
| 59899 |
|
12 |
12 |
$8K |
| 86140 |
|
898 |
795 |
$8K |
| 83735 |
|
2,951 |
2,047 |
$8K |
| 72100 |
|
229 |
211 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
373 |
344 |
$8K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
147 |
139 |
$8K |
| 80076 |
|
1,115 |
924 |
$8K |
| 81001 |
|
8,918 |
7,775 |
$7K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
70 |
43 |
$7K |
| J3490 |
Unclassified drugs |
1,825 |
969 |
$7K |
| 76642 |
|
48 |
46 |
$7K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
501 |
465 |
$7K |
| 73030 |
|
275 |
232 |
$7K |
| 86038 |
|
311 |
265 |
$6K |
| 87186 |
|
1,303 |
983 |
$6K |
| 82565 |
|
829 |
614 |
$6K |
| 83550 |
|
1,041 |
953 |
$6K |
| 73630 |
|
308 |
275 |
$6K |
| 84153 |
|
356 |
319 |
$6K |
| 86850 |
|
237 |
204 |
$5K |
| 84702 |
|
240 |
148 |
$5K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
58 |
54 |
$5K |
| 83615 |
|
1,047 |
900 |
$4K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
13 |
12 |
$4K |
| 82746 |
|
595 |
521 |
$4K |
| 85652 |
|
1,057 |
945 |
$4K |
| 87400 |
|
385 |
330 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
3,082 |
2,667 |
$4K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
777 |
600 |
$4K |
| 87070 |
|
389 |
330 |
$3K |
| 73562 |
|
140 |
132 |
$3K |
| 84520 |
|
724 |
526 |
$3K |
| 85610 |
|
2,642 |
1,861 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
25 |
25 |
$3K |
| 87205 |
|
558 |
460 |
$3K |
| 83690 |
|
4,394 |
3,700 |
$3K |
| 73502 |
|
129 |
127 |
$3K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,105 |
4,420 |
$3K |
| 83880 |
|
773 |
649 |
$3K |
| 82043 |
|
495 |
462 |
$3K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
41 |
25 |
$3K |
| 82784 |
|
508 |
223 |
$3K |
| 71271 |
|
12 |
12 |
$3K |
| 86900 |
|
239 |
205 |
$2K |
| 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 |
368 |
322 |
$2K |
| 84100 |
|
924 |
670 |
$2K |
| 73610 |
|
140 |
123 |
$2K |
| 80306 |
|
582 |
489 |
$2K |
| 84703 |
|
1,857 |
1,543 |
$2K |
| 97535 |
Self-care/home management training, each 15 minutes |
38 |
30 |
$2K |
| 84460 |
|
388 |
274 |
$2K |
| 94060 |
|
12 |
12 |
$2K |
| 82948 |
|
1,562 |
690 |
$2K |
| 84450 |
|
316 |
217 |
$2K |
| 73130 |
|
148 |
125 |
$2K |
| 97166 |
|
28 |
24 |
$2K |
| 83605 |
|
1,461 |
1,026 |
$2K |
| 71250 |
|
12 |
12 |
$2K |
| 86430 |
|
122 |
109 |
$1K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
84 |
74 |
$1K |
| 82077 |
|
378 |
289 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
810 |
609 |
$1K |
| 85379 |
|
794 |
688 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,895 |
1,480 |
$1K |
| 93971 |
|
12 |
12 |
$1K |
| 84550 |
|
276 |
233 |
$1K |
| 72040 |
|
16 |
16 |
$1K |
| 86901 |
|
239 |
205 |
$961.90 |
| 85730 |
|
1,471 |
1,203 |
$923.86 |
| 93017 |
|
16 |
13 |
$916.98 |
| 86706 |
|
77 |
70 |
$856.58 |
| 94727 |
|
14 |
14 |
$817.40 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,176 |
893 |
$815.29 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
482 |
420 |
$779.78 |
| 82550 |
|
189 |
157 |
$769.79 |
| 97533 |
|
19 |
12 |
$766.64 |
| 86235 |
|
78 |
25 |
$729.40 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,128 |
1,018 |
$686.86 |
| 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 |
278 |
202 |
$638.05 |
| 82947 |
|
123 |
86 |
$625.36 |
| 83883 |
|
62 |
26 |
$600.79 |
| 80346 |
|
53 |
50 |
$579.32 |
| 87340 |
|
43 |
41 |
$520.77 |
| 84481 |
|
26 |
25 |
$501.15 |
| 73560 |
|
27 |
26 |
$489.19 |
| 83992 |
|
39 |
37 |
$473.00 |
| 81025 |
|
859 |
724 |
$456.72 |
| 83516 |
|
29 |
25 |
$439.25 |
| 94729 |
|
12 |
12 |
$434.35 |
| 90715 |
|
26 |
24 |
$395.12 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
3,495 |
3,003 |
$353.37 |
| 96376 |
|
312 |
227 |
$352.75 |
| 80358 |
|
53 |
50 |
$347.83 |
| 80364 |
|
53 |
50 |
$347.83 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,226 |
2,574 |
$336.39 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
636 |
344 |
$301.41 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
27 |
26 |
$277.24 |
| 84156 |
|
147 |
112 |
$255.82 |
| 80331 |
|
53 |
50 |
$250.48 |
| 82803 |
|
253 |
179 |
$238.59 |
| 80353 |
|
53 |
50 |
$236.10 |
| 80326 |
|
53 |
50 |
$236.10 |
| 87040 |
|
908 |
443 |
$235.41 |
| 82570 |
|
148 |
116 |
$233.91 |
| 80348 |
|
39 |
37 |
$224.85 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
623 |
426 |
$205.81 |
| 73110 |
|
15 |
12 |
$169.15 |
| 84165 |
|
43 |
38 |
$162.56 |
| 82140 |
|
15 |
15 |
$126.84 |
| 80334 |
|
39 |
37 |
$126.25 |
| 80357 |
|
39 |
37 |
$121.00 |
| 80371 |
|
39 |
37 |
$121.00 |
| 80367 |
|
39 |
37 |
$121.00 |
| 80359 |
|
39 |
37 |
$121.00 |
| 80368 |
|
39 |
37 |
$121.00 |
| 80341 |
|
39 |
37 |
$121.00 |
| 80344 |
|
39 |
37 |
$121.00 |
| 80354 |
|
39 |
37 |
$121.00 |
| 80377 |
|
39 |
37 |
$121.00 |
| 80338 |
|
39 |
37 |
$121.00 |
| 80366 |
|
39 |
37 |
$121.00 |
| 80373 |
|
39 |
37 |
$121.00 |
| 80360 |
|
39 |
37 |
$121.00 |
| 80355 |
|
39 |
37 |
$121.00 |
| 80365 |
|
39 |
37 |
$121.00 |
| 80370 |
|
39 |
37 |
$121.00 |
| 80372 |
|
39 |
37 |
$121.00 |
| 80337 |
|
39 |
37 |
$121.00 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
505 |
204 |
$103.48 |
| 86334 |
|
14 |
12 |
$91.63 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
159 |
129 |
$88.06 |
| 86200 |
|
15 |
14 |
$79.56 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,205 |
1,763 |
$72.70 |
| 80361 |
|
26 |
25 |
$66.00 |
| 82150 |
|
14 |
12 |
$57.81 |
| J2704 |
Injection, propofol, 10 mg |
2,268 |
1,765 |
$44.39 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,433 |
2,591 |
$41.13 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
924 |
511 |
$26.64 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
452 |
345 |
$24.40 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
612 |
445 |
$17.70 |
| J1630 |
Injection, haloperidol, up to 5 mg |
351 |
263 |
$16.20 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,067 |
832 |
$15.40 |
| 86160 |
|
17 |
14 |
$15.12 |
| 86225 |
|
16 |
13 |
$15.12 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,070 |
862 |
$15.08 |
| J1644 |
Injection, heparin sodium, per 1000 units |
113 |
55 |
$14.39 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
415 |
311 |
$13.46 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
69 |
39 |
$10.58 |
| J7050 |
Infusion, normal saline solution, 250 cc |
101 |
69 |
$6.43 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
331 |
237 |
$6.40 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
564 |
434 |
$6.40 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
58 |
44 |
$5.10 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
177 |
131 |
$4.40 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
804 |
655 |
$3.68 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
638 |
461 |
$0.01 |
| A9270 |
Non-covered item or service |
1,321 |
179 |
$0.00 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
119 |
109 |
$0.00 |
| 64484 |
|
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
24 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
15 |
13 |
$0.00 |
| 64494 |
|
12 |
12 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
193 |
170 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
81 |
73 |
$0.00 |
| 01992 |
|
192 |
172 |
$0.00 |
| 80179 |
|
17 |
15 |
$0.00 |
| 80143 |
|
18 |
16 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
27 |
20 |
$0.00 |