| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
837 |
761 |
$432K |
| 99284 |
|
4,108 |
3,754 |
$394K |
| 99285 |
|
2,327 |
2,066 |
$279K |
| 99283 |
|
3,034 |
2,696 |
$180K |
| 90834 |
|
351 |
254 |
$19K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
481 |
455 |
$15K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,069 |
1,556 |
$12K |
| 99281 |
|
1,393 |
1,222 |
$8K |
| 80048 |
|
6,072 |
4,161 |
$7K |
| 87633 |
|
90 |
87 |
$7K |
| 90832 |
|
114 |
94 |
$4K |
| 93005 |
|
4,834 |
4,119 |
$3K |
| 71046 |
|
1,504 |
1,400 |
$3K |
| 84484 |
|
3,662 |
3,004 |
$3K |
| 70450 |
|
1,149 |
1,094 |
$2K |
| 83605 |
|
870 |
772 |
$2K |
| 80053 |
|
3,469 |
2,976 |
$2K |
| 99282 |
|
54 |
52 |
$1K |
| 85025 |
|
9,061 |
6,470 |
$701.18 |
| 74177 |
|
53 |
51 |
$516.40 |
| 71045 |
|
1,897 |
1,725 |
$386.86 |
| 74176 |
|
38 |
38 |
$249.22 |
| 81001 |
|
3,032 |
2,760 |
$203.11 |
| 83880 |
|
907 |
841 |
$157.19 |
| 80307 |
|
558 |
522 |
$155.16 |
| 0241U |
|
192 |
183 |
$142.63 |
| 80076 |
|
706 |
632 |
$124.89 |
| 87635 |
|
1,425 |
1,279 |
$95.96 |
| 83690 |
|
1,454 |
1,332 |
$85.55 |
| 85610 |
|
2,824 |
2,341 |
$80.14 |
| 83735 |
|
2,452 |
1,508 |
$66.24 |
| 84443 |
|
69 |
56 |
$29.88 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
264 |
204 |
$24.27 |
| 87804 |
|
126 |
122 |
$13.24 |
| 84100 |
|
1,122 |
634 |
$12.23 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
939 |
802 |
$10.32 |
| 85379 |
|
38 |
37 |
$9.16 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
362 |
313 |
$5.27 |
| 84703 |
|
108 |
102 |
$5.13 |
| 87086 |
|
83 |
78 |
$0.58 |
| J2272 |
Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg |
21 |
12 |
$0.00 |
| J1644 |
Injection, heparin sodium, per 1000 units |
65 |
27 |
$0.00 |
| G0380 |
Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
261 |
239 |
$0.00 |
| 87798 |
|
90 |
87 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
74 |
55 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
224 |
202 |
$0.00 |
| 87486 |
|
90 |
87 |
$0.00 |
| 82077 |
|
238 |
210 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
39 |
37 |
$0.00 |
| 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 |
343 |
307 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
296 |
173 |
$0.00 |
| 87581 |
|
90 |
87 |
$0.00 |
| 87428 |
|
36 |
35 |
$0.00 |
| 36415 |
|
23 |
12 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
19 |
12 |
$0.00 |
| 83036 |
|
36 |
36 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
13 |
12 |
$0.00 |
| 88305 |
|
13 |
12 |
$0.00 |