| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21,288 |
19,129 |
$2.73M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
17,306 |
16,357 |
$2.40M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
5,009 |
1,850 |
$1.82M |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
934 |
879 |
$931K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,742 |
2,972 |
$849K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,458 |
2,413 |
$761K |
| 80053 |
Comprehensive metabolic panel |
7,260 |
5,878 |
$303K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,112 |
1,945 |
$301K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,888 |
1,682 |
$278K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
8,008 |
6,386 |
$260K |
| 70450 |
Computed tomography, head or brain; without contrast material |
820 |
699 |
$260K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,283 |
2,030 |
$247K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,185 |
1,133 |
$243K |
| D2929 |
|
558 |
427 |
$236K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,085 |
1,867 |
$236K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,803 |
1,251 |
$223K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
2,127 |
1,886 |
$190K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,606 |
1,356 |
$185K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,627 |
2,297 |
$184K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,197 |
1,074 |
$172K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
2,009 |
1,465 |
$161K |
| 83605 |
|
2,394 |
1,908 |
$142K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
904 |
437 |
$140K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
704 |
386 |
$135K |
| 80306 |
|
1,009 |
906 |
$135K |
| 87400 |
|
1,809 |
1,333 |
$131K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
673 |
643 |
$130K |
| D1351 |
Sealant - per tooth |
784 |
446 |
$125K |
| 76801 |
|
488 |
444 |
$121K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
423 |
376 |
$114K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,714 |
2,453 |
$104K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,548 |
1,985 |
$101K |
| 71045 |
Radiologic examination, chest; single view |
1,826 |
1,440 |
$95K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
559 |
547 |
$94K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
472 |
303 |
$81K |
| 36415 |
Collection of venous blood by venipuncture |
5,680 |
4,393 |
$78K |
| 83690 |
|
1,614 |
1,449 |
$76K |
| 81025 |
|
1,860 |
1,764 |
$72K |
| 71046 |
Radiologic examination, chest; 2 views |
832 |
733 |
$67K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
99 |
96 |
$65K |
| 84484 |
|
1,545 |
1,089 |
$64K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
252 |
249 |
$56K |
| A0425 |
Ground mileage, per statute mile |
2,527 |
1,510 |
$51K |
| 76830 |
Ultrasound, transvaginal |
150 |
147 |
$43K |
| 86140 |
|
1,373 |
1,180 |
$37K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
312 |
275 |
$36K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,323 |
1,174 |
$33K |
| 87040 |
|
980 |
756 |
$32K |
| 87807 |
|
432 |
419 |
$30K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
787 |
774 |
$26K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
427 |
248 |
$24K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
107 |
79 |
$24K |
| 81015 |
|
1,288 |
1,188 |
$23K |
| D7140 |
Extraction, erupted tooth or exposed root |
51 |
50 |
$22K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
112 |
76 |
$22K |
| 36416 |
|
1,401 |
1,334 |
$22K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
561 |
547 |
$21K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
86 |
84 |
$20K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
124 |
122 |
$19K |
| D1206 |
Topical application of fluoride varnish |
798 |
782 |
$16K |
| 82948 |
|
971 |
572 |
$16K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
25 |
25 |
$16K |
| 87430 |
|
259 |
256 |
$14K |
| 85610 |
|
805 |
659 |
$12K |
| D9999 |
Unspecified adjunctive procedure, by report |
463 |
457 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
173 |
165 |
$9K |
| 76642 |
|
70 |
58 |
$9K |
| 97162 |
|
94 |
91 |
$8K |
| 83735 |
|
248 |
191 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
148 |
102 |
$6K |
| D1120 |
Prophylaxis - child |
805 |
786 |
$6K |
| 82150 |
|
251 |
217 |
$6K |
| 87186 |
|
222 |
180 |
$6K |
| 96376 |
|
46 |
42 |
$6K |
| 83880 |
|
137 |
103 |
$6K |
| 85730 |
|
231 |
205 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
96 |
85 |
$5K |
| 01967 |
Neuraxial labor analgesia/anesthesia for planned vaginal delivery |
29 |
26 |
$4K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
826 |
750 |
$3K |
| D0240 |
|
371 |
243 |
$3K |
| 12001 |
|
24 |
24 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
75 |
62 |
$3K |
| 82803 |
|
42 |
25 |
$2K |
| 87081 |
|
52 |
51 |
$2K |
| 83874 |
|
58 |
43 |
$2K |
| D0272 |
Bitewings - two radiographic images |
165 |
164 |
$2K |
| 82553 |
|
53 |
43 |
$1K |
| 87088 |
|
47 |
38 |
$920.24 |
| 82550 |
|
56 |
45 |
$896.15 |
| 85652 |
|
45 |
35 |
$698.96 |
| 85027 |
|
27 |
24 |
$554.20 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$204.97 |
| 99001 |
|
14 |
12 |
$0.00 |
| 80320 |
|
318 |
281 |
$0.00 |
| D0603 |
|
52 |
51 |
$0.00 |