| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
605 |
511 |
$165K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,014 |
1,568 |
$145K |
| J3490 |
Unclassified drugs |
1,725 |
900 |
$56K |
| 0450 |
Emergency room services |
630 |
529 |
$53K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
594 |
494 |
$51K |
| 70450 |
Computed tomography, head or brain; without contrast material |
186 |
168 |
$49K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
107 |
104 |
$40K |
| 80053 |
Comprehensive metabolic panel |
1,532 |
1,296 |
$33K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
860 |
719 |
$33K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
279 |
240 |
$32K |
| 77066 |
Tomosynthesis, mammo |
71 |
64 |
$25K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
362 |
304 |
$21K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
329 |
247 |
$18K |
| 77065 |
Tomosynthesis, mammo |
73 |
60 |
$18K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
174 |
156 |
$17K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,622 |
1,365 |
$16K |
| 76999 |
|
51 |
44 |
$15K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
105 |
96 |
$12K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
315 |
252 |
$12K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
107 |
102 |
$12K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
448 |
237 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
305 |
293 |
$11K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
119 |
105 |
$11K |
| 76830 |
Ultrasound, transvaginal |
107 |
94 |
$10K |
| 76642 |
|
118 |
101 |
$9K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
24 |
20 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
50 |
45 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
441 |
406 |
$8K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
98 |
85 |
$8K |
| 93971 |
|
36 |
34 |
$8K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
320 |
258 |
$8K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
69 |
37 |
$8K |
| 84484 |
|
511 |
402 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
162 |
130 |
$6K |
| 71250 |
|
23 |
17 |
$6K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
17 |
13 |
$6K |
| 86803 |
|
280 |
255 |
$6K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
101 |
93 |
$5K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
101 |
93 |
$5K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
16 |
13 |
$5K |
| 86703 |
|
262 |
240 |
$5K |
| 76536 |
|
57 |
49 |
$5K |
| G0297 |
Low dose ct scan (ldct) for lung cancer screening |
15 |
15 |
$5K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
397 |
310 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
134 |
99 |
$4K |
| 83690 |
|
414 |
360 |
$4K |
| 83880 |
|
93 |
81 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
323 |
272 |
$4K |
| 83605 |
|
246 |
140 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
266 |
165 |
$4K |
| 71020 |
|
92 |
77 |
$4K |
| 76801 |
|
39 |
36 |
$3K |
| J1815 |
Injection, insulin, per 5 units |
24 |
17 |
$3K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
43 |
41 |
$3K |
| 0510 |
|
45 |
42 |
$3K |
| 87040 |
|
188 |
99 |
$2K |
| 94729 |
|
32 |
31 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
208 |
191 |
$2K |
| 71010 |
|
95 |
88 |
$2K |
| 90715 |
|
42 |
35 |
$2K |
| 81001 |
|
414 |
373 |
$2K |
| 80047 |
|
83 |
74 |
$2K |
| 72100 |
|
47 |
41 |
$2K |
| 82947 |
|
150 |
124 |
$2K |
| 76770 |
|
19 |
16 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
109 |
101 |
$2K |
| 81025 |
|
236 |
206 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
20 |
16 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
54 |
45 |
$2K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
178 |
141 |
$2K |
| 73030 |
|
39 |
34 |
$2K |
| 72040 |
|
29 |
25 |
$2K |
| 84703 |
|
192 |
156 |
$1K |
| 84702 |
|
79 |
73 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
18 |
17 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
56 |
43 |
$1K |
| 73562 |
|
40 |
32 |
$1K |
| 83735 |
|
147 |
127 |
$1K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
16 |
12 |
$1K |
| 73610 |
|
32 |
30 |
$1K |
| 73630 |
|
32 |
29 |
$1K |
| 85610 |
|
222 |
196 |
$1K |
| 87400 |
|
147 |
129 |
$1K |
| 85730 |
|
131 |
118 |
$1K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
93 |
64 |
$1K |
| 94727 |
|
18 |
17 |
$1K |
| 77080 |
|
14 |
13 |
$998.30 |
| 90686 |
|
24 |
18 |
$912.96 |
| S0164 |
Injection, pantoprazole sodium, 40 mg |
45 |
38 |
$865.30 |
| 81003 |
|
215 |
187 |
$792.42 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
92 |
74 |
$737.64 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
13 |
12 |
$690.21 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
43 |
37 |
$676.03 |
| 73130 |
|
16 |
15 |
$633.08 |
| 85379 |
|
37 |
35 |
$617.51 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
38 |
29 |
$571.53 |
| 87077 |
|
61 |
51 |
$566.48 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
65 |
52 |
$550.34 |
| 87186 |
|
55 |
49 |
$545.96 |
| J2060 |
Injection, lorazepam, 2 mg |
77 |
63 |
$542.80 |
| 94644 |
|
16 |
14 |
$508.89 |
| J7050 |
Infusion, normal saline solution, 250 cc |
21 |
15 |
$507.03 |
| 87081 |
|
46 |
41 |
$472.23 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
259 |
187 |
$420.53 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
56 |
48 |
$395.91 |
| 87210 |
|
58 |
54 |
$350.22 |
| 86850 |
|
29 |
28 |
$258.42 |
| 85014 |
|
80 |
72 |
$237.15 |
| 86901 |
|
46 |
45 |
$225.03 |
| J1940 |
Injection, furosemide, up to 20 mg |
16 |
15 |
$224.26 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
18 |
15 |
$202.29 |
| 86900 |
|
48 |
43 |
$194.60 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
19 |
18 |
$156.90 |
| 99070 |
|
18 |
13 |
$62.12 |
| 0250 |
|
20 |
18 |
$10.74 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
35 |
34 |
$0.00 |
| 0250R |
|
15 |
14 |
$0.00 |