| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59025 |
Fetal non-stress test |
623 |
454 |
$139K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
355 |
266 |
$30K |
| 76641 |
|
39 |
38 |
$7K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
22 |
12 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
161 |
147 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
16 |
$4K |
| G0378 |
Hospital observation service, per hour |
21 |
13 |
$3K |
| 99070 |
|
63 |
42 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
56 |
42 |
$2K |
| 77066 |
Tomosynthesis, mammo |
42 |
41 |
$2K |
| J3490 |
Unclassified drugs |
389 |
157 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,154 |
820 |
$1K |
| 80053 |
Comprehensive metabolic panel |
180 |
128 |
$1K |
| 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 |
41 |
39 |
$1K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
28 |
27 |
$668.91 |
| 85027 |
|
153 |
140 |
$587.28 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
215 |
145 |
$329.49 |
| 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 |
39 |
37 |
$292.06 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
53 |
42 |
$273.65 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,205 |
770 |
$143.76 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
614 |
498 |
$83.62 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
590 |
285 |
$82.67 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
645 |
479 |
$64.86 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
345 |
301 |
$63.79 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
403 |
354 |
$57.61 |
| 82247 |
|
24 |
16 |
$41.20 |
| 86900 |
|
17 |
12 |
$40.38 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
423 |
374 |
$37.12 |
| 86901 |
|
17 |
12 |
$20.16 |
| 82962 |
|
24 |
14 |
$15.68 |
| 83615 |
|
37 |
28 |
$10.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
50 |
25 |
$9.66 |
| 81001 |
|
13 |
13 |
$6.52 |
| J2704 |
Injection, propofol, 10 mg |
810 |
694 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
65 |
42 |
$0.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
27 |
13 |
$0.00 |