| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,196 |
1,993 |
$458K |
| G0378 |
Hospital observation service, per hour |
292 |
257 |
$221K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,725 |
259 |
$199K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
949 |
849 |
$169K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
583 |
567 |
$142K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
174 |
170 |
$35K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
64 |
64 |
$21K |
| 71046 |
Radiologic examination, chest; 2 views |
252 |
243 |
$15K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
462 |
442 |
$11K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
12 |
12 |
$9K |
| 70450 |
Computed tomography, head or brain; without contrast material |
208 |
194 |
$9K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
64 |
64 |
$8K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
32 |
31 |
$8K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
752 |
643 |
$5K |
| 73630 |
|
33 |
32 |
$5K |
| 80053 |
Comprehensive metabolic panel |
1,058 |
922 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,689 |
1,265 |
$5K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
171 |
161 |
$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 |
127 |
116 |
$3K |
| 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 |
33 |
33 |
$2K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
384 |
362 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
453 |
363 |
$2K |
| 84703 |
|
367 |
356 |
$2K |
| 87631 |
|
57 |
56 |
$2K |
| 84484 |
|
536 |
448 |
$2K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
360 |
317 |
$1K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
288 |
248 |
$1K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
133 |
110 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
238 |
225 |
$900.55 |
| 71045 |
Radiologic examination, chest; single view |
278 |
261 |
$763.19 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
755 |
607 |
$674.71 |
| 81001 |
|
311 |
294 |
$533.47 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$458.97 |
| 83735 |
|
217 |
161 |
$440.22 |
| 83690 |
|
225 |
210 |
$403.52 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
38 |
37 |
$373.23 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
162 |
133 |
$343.91 |
| 81003 |
|
289 |
278 |
$324.93 |
| 85610 |
|
200 |
176 |
$313.62 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
264 |
241 |
$229.73 |
| 96376 |
|
18 |
12 |
$228.06 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
81 |
76 |
$183.68 |
| 87040 |
|
24 |
24 |
$171.42 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
71 |
54 |
$138.00 |
| 82962 |
|
235 |
180 |
$120.04 |
| J7050 |
Infusion, normal saline solution, 250 cc |
128 |
78 |
$104.67 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
75 |
66 |
$94.28 |
| 82550 |
|
29 |
26 |
$86.28 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
255 |
204 |
$78.72 |
| 83605 |
|
30 |
28 |
$67.20 |
| 94760 |
|
118 |
63 |
$65.84 |
| J3490 |
Unclassified drugs |
67 |
45 |
$34.31 |
| 85730 |
|
14 |
14 |
$30.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
47 |
42 |
$10.76 |
| 87186 |
|
13 |
12 |
$8.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
16 |
13 |
$7.54 |
| 87077 |
|
13 |
12 |
$7.10 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
15 |
12 |
$4.02 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
35 |
25 |
$3.27 |
| J2060 |
Injection, lorazepam, 2 mg |
19 |
18 |
$1.83 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
46 |
40 |
$1.64 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16 |
12 |
$0.00 |
| 00000 |
|
425 |
117 |
$0.00 |