| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,139 |
6,812 |
$3.23M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,343 |
3,117 |
$1.61M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12,537 |
12,246 |
$1.23M |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
5,235 |
5,109 |
$179K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
10,423 |
5,109 |
$152K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,184 |
3,128 |
$80K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
726 |
709 |
$76K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
2,655 |
2,606 |
$65K |
| 71045 |
Radiologic examination, chest; single view |
2,855 |
2,679 |
$56K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
992 |
921 |
$44K |
| 80053 |
Comprehensive metabolic panel |
5,483 |
5,031 |
$39K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,686 |
2,621 |
$33K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,237 |
1,097 |
$31K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,041 |
5,531 |
$29K |
| 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 |
291 |
274 |
$28K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
701 |
675 |
$27K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
68 |
64 |
$26K |
| 87807 |
|
1,505 |
1,467 |
$25K |
| G0378 |
Hospital observation service, per hour |
28 |
13 |
$15K |
| 90715 |
|
182 |
180 |
$13K |
| 81025 |
|
1,750 |
1,626 |
$11K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
911 |
825 |
$11K |
| 36415 |
Collection of venous blood by venipuncture |
8,570 |
7,809 |
$9K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
502 |
457 |
$9K |
| 87081 |
|
1,657 |
1,611 |
$8K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
90 |
88 |
$8K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
352 |
323 |
$7K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,442 |
1,232 |
$7K |
| 81003 |
|
3,610 |
3,247 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
25 |
24 |
$5K |
| 84484 |
|
954 |
586 |
$5K |
| 80047 |
|
558 |
519 |
$5K |
| 59025 |
Fetal non-stress test |
31 |
26 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
261 |
251 |
$4K |
| 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 |
100 |
99 |
$4K |
| 83690 |
|
893 |
836 |
$4K |
| 81001 |
|
1,554 |
1,478 |
$3K |
| 83605 |
|
457 |
362 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
49 |
48 |
$3K |
| 87428 |
|
280 |
278 |
$3K |
| 81404 |
|
15 |
15 |
$3K |
| 85610 |
|
1,080 |
1,021 |
$3K |
| 85730 |
|
639 |
608 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
71 |
65 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
331 |
313 |
$2K |
| 83789 |
|
102 |
54 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
219 |
210 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
424 |
392 |
$2K |
| 84145 |
|
90 |
87 |
$2K |
| 82261 |
|
70 |
69 |
$2K |
| 81402 |
|
15 |
15 |
$1K |
| 83021 |
|
55 |
54 |
$1K |
| 90686 |
|
41 |
39 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
14 |
14 |
$1K |
| 83491 |
|
55 |
54 |
$1K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
273 |
239 |
$1K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
41 |
39 |
$1K |
| 82776 |
|
70 |
69 |
$1K |
| 83020 |
|
55 |
54 |
$921.90 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,844 |
1,623 |
$893.58 |
| 83498 |
|
15 |
15 |
$840.43 |
| 83516 |
|
55 |
54 |
$825.85 |
| 90674 |
|
14 |
14 |
$814.41 |
| 81479 |
Unlisted molecular pathology procedure |
71 |
69 |
$703.20 |
| J7510 |
Prednisolone oral, per 5 mg |
180 |
171 |
$690.44 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
69 |
67 |
$664.39 |
| 84437 |
|
70 |
69 |
$662.75 |
| 82726 |
|
15 |
15 |
$611.01 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
12 |
12 |
$599.72 |
| 83520 |
|
15 |
15 |
$534.36 |
| 82016 |
|
15 |
15 |
$510.04 |
| 83919 |
|
15 |
15 |
$509.00 |
| 86141 |
|
42 |
42 |
$487.17 |
| 82128 |
|
15 |
15 |
$429.02 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
137 |
116 |
$368.44 |
| 84702 |
|
30 |
27 |
$366.56 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
114 |
113 |
$347.35 |
| 81401 |
|
15 |
15 |
$337.13 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
193 |
161 |
$253.78 |
| 86140 |
|
46 |
42 |
$249.58 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
342 |
324 |
$236.29 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
12 |
$217.33 |
| 87040 |
|
31 |
18 |
$213.30 |
| 83735 |
|
41 |
39 |
$178.40 |
| 83880 |
|
15 |
14 |
$170.38 |
| 85027 |
|
26 |
26 |
$149.77 |
| 36416 |
|
50 |
50 |
$93.27 |
| 87186 |
|
12 |
12 |
$90.88 |
| 85007 |
|
25 |
25 |
$87.22 |
| 88720 |
|
12 |
12 |
$72.33 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
34 |
25 |
$21.10 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
18 |
16 |
$17.17 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
46 |
39 |
$7.25 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
42 |
39 |
$0.00 |
| A9270 |
Non-covered item or service |
546 |
298 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
15 |
13 |
$0.00 |