| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
13,369 |
9,613 |
$1.93M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
10,629 |
6,734 |
$1.50M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
958 |
751 |
$724K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,871 |
2,182 |
$669K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
5,352 |
4,145 |
$655K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,321 |
1,170 |
$395K |
| G0378 |
Hospital observation service, per hour |
1,458 |
500 |
$363K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,233 |
902 |
$348K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,658 |
1,633 |
$264K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,527 |
1,762 |
$192K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,459 |
1,643 |
$188K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,145 |
618 |
$148K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,765 |
1,973 |
$143K |
| 71046 |
Radiologic examination, chest; 2 views |
1,928 |
1,420 |
$140K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
2,922 |
2,355 |
$129K |
| J3490 |
Unclassified drugs |
14,971 |
4,779 |
$114K |
| 71045 |
Radiologic examination, chest; single view |
2,152 |
1,554 |
$112K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
758 |
491 |
$71K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,867 |
2,804 |
$69K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,743 |
2,149 |
$63K |
| 80053 |
Comprehensive metabolic panel |
11,104 |
7,961 |
$60K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,340 |
2,235 |
$56K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,623 |
1,223 |
$54K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13,044 |
8,722 |
$51K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,050 |
828 |
$38K |
| J7050 |
Infusion, normal saline solution, 250 cc |
2,773 |
1,329 |
$34K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
62 |
53 |
$33K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
159 |
135 |
$30K |
| 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 |
984 |
744 |
$29K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
672 |
314 |
$29K |
| 59025 |
Fetal non-stress test |
198 |
67 |
$28K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
537 |
391 |
$27K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
289 |
281 |
$26K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,123 |
1,003 |
$23K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,120 |
1,000 |
$23K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,302 |
1,904 |
$22K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
427 |
309 |
$20K |
| J2704 |
Injection, propofol, 10 mg |
987 |
698 |
$19K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
2,568 |
1,811 |
$17K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
826 |
608 |
$16K |
| 76830 |
Ultrasound, transvaginal |
71 |
63 |
$16K |
| 84484 |
|
3,433 |
2,062 |
$14K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
153 |
113 |
$14K |
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
203 |
159 |
$11K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,420 |
1,961 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
832 |
464 |
$9K |
| 83735 |
|
2,681 |
1,650 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
246 |
110 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,892 |
1,185 |
$9K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,953 |
1,364 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
17,759 |
11,764 |
$8K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
133 |
80 |
$8K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,566 |
1,253 |
$8K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,066 |
1,382 |
$8K |
| 83880 |
|
626 |
418 |
$8K |
| 83690 |
|
2,084 |
1,518 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
917 |
535 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
49 |
43 |
$7K |
| 80061 |
Lipid panel |
743 |
645 |
$7K |
| 87660 |
|
452 |
371 |
$7K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
295 |
264 |
$6K |
| 87510 |
|
456 |
371 |
$6K |
| 87480 |
|
456 |
371 |
$6K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
16 |
12 |
$6K |
| 86850 |
|
741 |
615 |
$6K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,077 |
905 |
$6K |
| 81025 |
|
1,278 |
1,015 |
$6K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
113 |
94 |
$5K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
350 |
107 |
$5K |
| 87081 |
|
1,049 |
947 |
$5K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
776 |
430 |
$5K |
| 97161 |
|
54 |
46 |
$5K |
| 83605 |
|
1,011 |
678 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
159 |
135 |
$4K |
| 87186 |
|
882 |
647 |
$4K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
44 |
25 |
$4K |
| 87040 |
|
745 |
450 |
$4K |
| 85027 |
|
799 |
682 |
$4K |
| 81003 |
|
3,372 |
2,694 |
$3K |
| 85610 |
|
1,762 |
1,204 |
$3K |
| 81001 |
|
2,017 |
1,522 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
14 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
117 |
83 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
13 |
$3K |
| 86140 |
|
876 |
670 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
631 |
473 |
$3K |
| 87088 |
|
985 |
747 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
126 |
111 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
99 |
96 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
560 |
309 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
292 |
240 |
$2K |
| 99406 |
|
75 |
45 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
216 |
127 |
$2K |
| 82947 |
|
1,310 |
646 |
$2K |
| 85730 |
|
651 |
471 |
$2K |
| 85379 |
|
279 |
192 |
$2K |
| 73564 |
|
14 |
12 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
245 |
190 |
$2K |
| 73030 |
|
18 |
13 |
$2K |
| 72100 |
|
16 |
13 |
$1K |
| 82728 |
|
142 |
124 |
$1K |
| 85652 |
|
736 |
583 |
$1K |
| 73630 |
|
14 |
13 |
$1K |
| 73610 |
|
18 |
14 |
$1K |
| 96376 |
|
184 |
133 |
$1K |
| 86901 |
|
532 |
435 |
$1K |
| 86900 |
|
513 |
422 |
$1K |
| 87449 |
|
141 |
116 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
59 |
36 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
97 |
50 |
$1K |
| 84703 |
|
200 |
152 |
$1K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
42 |
39 |
$889.44 |
| 87077 |
|
122 |
98 |
$882.28 |
| 92551 |
|
165 |
119 |
$797.00 |
| 82550 |
|
142 |
110 |
$663.24 |
| 86803 |
|
57 |
56 |
$592.86 |
| 82607 |
|
73 |
63 |
$577.29 |
| 86317 |
|
47 |
38 |
$509.92 |
| 84439 |
|
76 |
68 |
$450.61 |
| 99217 |
|
15 |
12 |
$431.55 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
30 |
25 |
$410.13 |
| 86762 |
|
38 |
37 |
$404.84 |
| 87205 |
|
153 |
124 |
$389.65 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
347 |
233 |
$386.70 |
| 82805 |
|
17 |
12 |
$351.20 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
99 |
68 |
$344.71 |
| 87340 |
|
42 |
41 |
$326.62 |
| J1790 |
Injection, droperidol, up to 5 mg |
42 |
30 |
$282.82 |
| 87070 |
|
46 |
42 |
$260.76 |
| 86592 |
|
71 |
68 |
$220.18 |
| 83540 |
|
40 |
38 |
$199.83 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
169 |
115 |
$195.25 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
129 |
78 |
$174.00 |
| 80050 |
General health panel |
26 |
25 |
$173.25 |
| 86618 |
|
15 |
13 |
$138.67 |
| 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 |
20 |
16 |
$133.25 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
13 |
12 |
$103.76 |
| 84100 |
|
44 |
36 |
$101.87 |
| 83550 |
|
12 |
12 |
$96.47 |
| 82375 |
|
17 |
12 |
$94.95 |
| 80354 |
|
202 |
154 |
$79.00 |
| 82950 |
|
18 |
15 |
$74.23 |
| A9270 |
Non-covered item or service |
73 |
38 |
$73.28 |
| 99173 |
|
124 |
93 |
$66.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15 |
15 |
$62.72 |
| 85018 |
|
33 |
24 |
$44.43 |
| 85014 |
|
33 |
24 |
$44.43 |
| 81015 |
|
93 |
64 |
$39.32 |
| 90474 |
|
46 |
30 |
$21.00 |
| 90723 |
|
50 |
32 |
$0.00 |
| 90680 |
|
48 |
30 |
$0.00 |
| 90686 |
|
47 |
28 |
$0.00 |
| 90648 |
|
82 |
53 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
121 |
86 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
12 |
$0.00 |
| 90670 |
|
99 |
67 |
$0.00 |
| 90685 |
|
34 |
19 |
$0.00 |
| 90710 |
|
19 |
12 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |