| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
5,966 |
3,779 |
$977K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
4,873 |
3,047 |
$635K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,536 |
1,120 |
$632K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,812 |
2,252 |
$620K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,586 |
2,875 |
$504K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,532 |
991 |
$303K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,909 |
2,401 |
$253K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,135 |
1,015 |
$234K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,772 |
1,160 |
$234K |
| 70450 |
Computed tomography, head or brain; without contrast material |
961 |
559 |
$193K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
773 |
506 |
$181K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,395 |
1,206 |
$91K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,778 |
2,423 |
$90K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,202 |
652 |
$42K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
455 |
413 |
$37K |
| 80053 |
Comprehensive metabolic panel |
4,905 |
3,670 |
$31K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,890 |
4,960 |
$28K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,285 |
956 |
$27K |
| 11721 |
|
1,184 |
671 |
$25K |
| 71046 |
Radiologic examination, chest; 2 views |
1,614 |
958 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,107 |
952 |
$16K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,213 |
2,443 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,897 |
1,316 |
$14K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
313 |
254 |
$13K |
| 84484 |
|
2,650 |
1,382 |
$12K |
| 80061 |
Lipid panel |
885 |
806 |
$12K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,205 |
1,103 |
$11K |
| 84443 |
Thyroid stimulating hormone (TSH) |
910 |
798 |
$11K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
43 |
36 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
289 |
125 |
$8K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,563 |
1,281 |
$7K |
| 82565 |
|
1,911 |
1,493 |
$7K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
26 |
17 |
$7K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
384 |
350 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
982 |
761 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
2,562 |
1,451 |
$5K |
| 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 |
123 |
100 |
$5K |
| 81001 |
|
2,497 |
1,989 |
$5K |
| 84145 |
|
486 |
411 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
5,656 |
3,787 |
$5K |
| 83690 |
|
1,159 |
927 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
446 |
139 |
$5K |
| 83605 |
|
939 |
661 |
$4K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
18 |
12 |
$4K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
77 |
62 |
$3K |
| 87081 |
|
405 |
359 |
$3K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,996 |
1,484 |
$3K |
| 83735 |
|
774 |
601 |
$3K |
| 80051 |
|
541 |
433 |
$3K |
| 84460 |
|
616 |
479 |
$2K |
| 85610 |
|
875 |
588 |
$2K |
| 81003 |
|
1,331 |
1,087 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
12 |
12 |
$2K |
| 87077 |
|
521 |
373 |
$2K |
| 81025 |
|
293 |
237 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
12 |
$2K |
| 85379 |
|
325 |
289 |
$2K |
| 87040 |
|
425 |
174 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
307 |
145 |
$1K |
| 87186 |
|
267 |
205 |
$1K |
| 85027 |
|
224 |
167 |
$1K |
| 84703 |
|
155 |
137 |
$972.35 |
| 82962 |
|
573 |
289 |
$959.31 |
| 86140 |
|
274 |
241 |
$885.23 |
| 0011A |
|
35 |
25 |
$844.66 |
| 82947 |
|
214 |
188 |
$752.23 |
| 96127 |
|
21 |
15 |
$741.20 |
| 84450 |
|
154 |
127 |
$580.96 |
| 0012A |
|
17 |
12 |
$552.64 |
| 90686 |
|
14 |
13 |
$472.35 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,045 |
1,433 |
$470.74 |
| 84132 |
|
108 |
89 |
$445.78 |
| 84439 |
|
66 |
63 |
$438.47 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
2,613 |
1,781 |
$349.82 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,179 |
639 |
$294.93 |
| 73630 |
|
42 |
26 |
$244.47 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
918 |
701 |
$238.38 |
| 82247 |
|
58 |
52 |
$176.96 |
| 84075 |
|
45 |
39 |
$154.81 |
| 82728 |
|
17 |
14 |
$126.72 |
| 82040 |
|
27 |
26 |
$118.87 |
| 82043 |
|
14 |
13 |
$104.99 |
| 82310 |
|
29 |
24 |
$98.11 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
23 |
13 |
$88.17 |
| 86900 |
|
14 |
13 |
$75.72 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,070 |
1,043 |
$74.19 |
| J7050 |
Infusion, normal saline solution, 250 cc |
3,482 |
1,792 |
$73.84 |
| 83550 |
|
14 |
13 |
$72.24 |
| 83540 |
|
14 |
13 |
$53.52 |
| 86850 |
|
14 |
13 |
$43.04 |
| 84520 |
|
16 |
13 |
$36.72 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
952 |
695 |
$24.76 |
| 86901 |
|
14 |
13 |
$24.72 |
| 91301 |
|
22 |
15 |
$19.73 |
| 85652 |
|
15 |
13 |
$19.53 |
| 80050 |
General health panel |
15 |
13 |
$16.86 |
| A9270 |
Non-covered item or service |
2,839 |
761 |
$15.60 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
899 |
615 |
$13.58 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
437 |
341 |
$2.35 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
16 |
14 |
$0.79 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
30 |
25 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
22 |
13 |
$0.00 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
15 |
15 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
24 |
12 |
$0.00 |