| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
5,530 |
5,025 |
$161K |
| 0121 |
|
55 |
27 |
$150K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
688 |
652 |
$62K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,527 |
1,969 |
$50K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
892 |
823 |
$34K |
| 0760 |
|
950 |
841 |
$31K |
| 70450 |
Computed tomography, head or brain; without contrast material |
295 |
285 |
$27K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,088 |
1,913 |
$18K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
503 |
471 |
$18K |
| 80053 |
Comprehensive metabolic panel |
3,597 |
3,122 |
$16K |
| 0510 |
|
603 |
541 |
$15K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
335 |
81 |
$13K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
542 |
505 |
$11K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
380 |
323 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
711 |
684 |
$11K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
252 |
241 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,968 |
3,391 |
$10K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,719 |
1,594 |
$10K |
| 0270 |
|
1,185 |
609 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
56 |
55 |
$9K |
| J3490 |
Unclassified drugs |
3,310 |
1,822 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
759 |
713 |
$6K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
174 |
134 |
$4K |
| 0700 |
|
93 |
79 |
$4K |
| 84484 |
|
822 |
674 |
$4K |
| A4663 |
Blood pressure cuff only |
614 |
570 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
208 |
197 |
$3K |
| 0258 |
|
339 |
211 |
$2K |
| 81003 |
|
1,753 |
1,600 |
$2K |
| 93975 |
|
17 |
17 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
360 |
335 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
549 |
511 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
367 |
322 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
331 |
310 |
$2K |
| 83690 |
|
429 |
406 |
$2K |
| A9270 |
Non-covered item or service |
2,188 |
583 |
$2K |
| 82948 |
|
396 |
320 |
$1K |
| 81025 |
|
218 |
211 |
$1K |
| 0259 |
|
265 |
154 |
$1K |
| 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 |
29 |
27 |
$944.26 |
| 73130 |
|
43 |
40 |
$943.29 |
| 80047 |
|
293 |
279 |
$938.42 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
458 |
391 |
$923.35 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
222 |
212 |
$895.12 |
| 73630 |
|
47 |
43 |
$833.77 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
28 |
25 |
$803.85 |
| 86803 |
|
279 |
268 |
$769.07 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
204 |
193 |
$748.19 |
| 73610 |
|
43 |
42 |
$748.13 |
| A4301 |
Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.) |
220 |
160 |
$507.54 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
13 |
12 |
$490.75 |
| 73110 |
|
28 |
28 |
$450.69 |
| A4306 |
Disposable drug delivery system, flow rate of less than 50 ml per hour |
250 |
231 |
$447.50 |
| 82947 |
|
111 |
89 |
$417.21 |
| 94760 |
|
102 |
92 |
$361.20 |
| 83605 |
|
76 |
72 |
$336.89 |
| 73030 |
|
17 |
17 |
$329.26 |
| 85610 |
|
179 |
159 |
$271.26 |
| 73562 |
|
16 |
15 |
$252.26 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16 |
13 |
$243.54 |
| 99221 |
|
13 |
12 |
$236.32 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
93 |
92 |
$191.61 |
| 90656 |
|
12 |
12 |
$174.77 |
| 36415 |
Collection of venous blood by venipuncture |
1,456 |
1,323 |
$137.94 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$122.35 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14 |
12 |
$103.82 |
| Q4051 |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
24 |
18 |
$99.20 |
| 85048 |
|
103 |
96 |
$96.91 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
43 |
36 |
$90.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$81.59 |
| 82550 |
|
16 |
12 |
$62.70 |
| 0271 |
|
58 |
28 |
$60.68 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
13 |
$52.12 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
13 |
12 |
$50.96 |
| 0250 |
|
75 |
39 |
$46.45 |
| 86901 |
|
12 |
12 |
$44.34 |
| 87210 |
|
12 |
12 |
$39.08 |
| 86900 |
|
12 |
12 |
$38.98 |
| 85027 |
|
13 |
12 |
$38.46 |
| 83735 |
|
15 |
12 |
$32.74 |
| 85730 |
|
13 |
12 |
$25.08 |
| 99499 |
|
401 |
364 |
$0.00 |
| 0300 |
|
15 |
12 |
$0.00 |
| 0301 |
|
15 |
12 |
$0.00 |
| 0305 |
|
15 |
12 |
$0.00 |
| 0636 |
|
15 |
12 |
$0.00 |