| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0378 |
Hospital observation service, per hour |
513 |
477 |
$1.16M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,128 |
2,854 |
$1.13M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,464 |
3,184 |
$991K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,746 |
2,554 |
$906K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
604 |
495 |
$149K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
190 |
93 |
$69K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
324 |
308 |
$21K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
126 |
117 |
$17K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
740 |
666 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
130 |
122 |
$8K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
225 |
201 |
$8K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
178 |
168 |
$5K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
19 |
19 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,956 |
1,621 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,062 |
1,679 |
$4K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
540 |
476 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
235 |
227 |
$4K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,414 |
1,248 |
$3K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
489 |
465 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
930 |
847 |
$2K |
| 80076 |
|
1,016 |
931 |
$2K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
820 |
759 |
$2K |
| 83735 |
|
1,065 |
893 |
$1K |
| 73564 |
|
93 |
83 |
$1K |
| 84484 |
|
689 |
588 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
41 |
41 |
$1K |
| 83880 |
|
199 |
183 |
$1K |
| 93975 |
|
40 |
38 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
397 |
245 |
$1K |
| 82805 |
|
184 |
171 |
$916.75 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
13 |
13 |
$892.56 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$890.96 |
| 73630 |
|
92 |
81 |
$728.54 |
| 93041 |
|
617 |
570 |
$682.34 |
| 82550 |
|
529 |
469 |
$607.67 |
| 84702 |
|
206 |
194 |
$550.07 |
| 80320 |
|
90 |
85 |
$527.46 |
| 90715 |
|
99 |
96 |
$515.41 |
| 73030 |
|
31 |
29 |
$515.37 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
370 |
339 |
$515.34 |
| 85730 |
|
322 |
298 |
$389.28 |
| 73130 |
|
126 |
119 |
$360.34 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
492 |
468 |
$356.90 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
492 |
468 |
$356.00 |
| 80053 |
Comprehensive metabolic panel |
42 |
28 |
$352.35 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
270 |
252 |
$348.04 |
| 80305 |
|
92 |
84 |
$347.13 |
| 83690 |
|
487 |
450 |
$335.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
192 |
184 |
$263.81 |
| 85610 |
|
348 |
315 |
$236.83 |
| 84443 |
Thyroid stimulating hormone (TSH) |
53 |
53 |
$229.73 |
| 82330 |
|
183 |
170 |
$219.78 |
| 36600 |
|
76 |
69 |
$209.26 |
| 83605 |
|
188 |
172 |
$200.72 |
| 81025 |
|
1,027 |
946 |
$198.30 |
| 36415 |
Collection of venous blood by venipuncture |
508 |
291 |
$149.62 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
42 |
40 |
$142.01 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
110 |
101 |
$105.17 |
| 73610 |
|
16 |
15 |
$94.34 |
| 84100 |
|
254 |
201 |
$93.07 |
| 81001 |
|
157 |
150 |
$82.34 |
| 85379 |
|
43 |
43 |
$68.90 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
278 |
227 |
$47.73 |
| 81003 |
|
93 |
92 |
$44.86 |
| 87186 |
|
12 |
12 |
$36.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
263 |
234 |
$35.15 |
| 86901 |
|
32 |
28 |
$29.06 |
| 86900 |
|
32 |
28 |
$28.72 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
118 |
84 |
$22.52 |
| 84295 |
|
96 |
86 |
$19.50 |
| 84132 |
|
99 |
88 |
$19.02 |
| 82435 |
|
96 |
86 |
$19.02 |
| 80051 |
|
42 |
42 |
$14.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
187 |
159 |
$12.81 |
| 86885 |
|
18 |
15 |
$7.90 |
| 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 |
324 |
286 |
$5.80 |
| J2060 |
Injection, lorazepam, 2 mg |
92 |
80 |
$4.37 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
211 |
179 |
$2.98 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
236 |
211 |
$1.78 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
34 |
25 |
$0.00 |
| A9270 |
Non-covered item or service |
3,833 |
1,628 |
$0.00 |
| J1630 |
Injection, haloperidol, up to 5 mg |
29 |
28 |
$0.00 |
| 82077 |
|
81 |
78 |
$0.00 |