| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
895 |
765 |
$72K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
503 |
408 |
$45K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
201 |
153 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
365 |
358 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
304 |
288 |
$16K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
244 |
89 |
$8K |
| 64415 |
|
43 |
39 |
$6K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
170 |
168 |
$6K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
51 |
35 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
87 |
79 |
$5K |
| 80053 |
Comprehensive metabolic panel |
721 |
583 |
$4K |
| 64483 |
|
12 |
12 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
184 |
152 |
$2K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
89 |
75 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
844 |
662 |
$2K |
| 85610 |
|
189 |
167 |
$1K |
| 81001 |
|
440 |
364 |
$698.12 |
| 85730 |
|
171 |
151 |
$682.95 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
39 |
38 |
$650.39 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
204 |
134 |
$525.67 |
| 73130 |
|
46 |
39 |
$500.75 |
| J3490 |
Unclassified drugs |
244 |
141 |
$414.63 |
| 71046 |
Radiologic examination, chest; 2 views |
119 |
92 |
$392.52 |
| 87641 |
|
13 |
12 |
$357.49 |
| 73110 |
|
16 |
16 |
$224.90 |
| 36415 |
Collection of venous blood by venipuncture |
1,009 |
757 |
$223.82 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
43 |
40 |
$144.54 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
76 |
44 |
$100.34 |
| 72100 |
|
209 |
174 |
$75.02 |
| 82947 |
|
67 |
28 |
$67.26 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
182 |
132 |
$55.51 |
| J0689 |
Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg |
535 |
415 |
$49.68 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,848 |
1,332 |
$47.80 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
93 |
61 |
$43.73 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
311 |
238 |
$27.75 |
| 81025 |
|
531 |
421 |
$25.65 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
959 |
703 |
$22.69 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,453 |
918 |
$21.01 |
| J2704 |
Injection, propofol, 10 mg |
1,443 |
1,080 |
$19.50 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
191 |
134 |
$15.59 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,143 |
735 |
$12.00 |
| 81003 |
|
43 |
40 |
$8.93 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,195 |
899 |
$8.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,218 |
943 |
$3.83 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
168 |
152 |
$3.33 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
132 |
104 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
137 |
115 |
$0.00 |
| 94760 |
|
19 |
13 |
$0.00 |
| 84484 |
|
45 |
27 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
468 |
275 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
63 |
52 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
25 |
20 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
12 |
12 |
$0.00 |
| 85027 |
|
17 |
13 |
$0.00 |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
90 |
89 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
261 |
196 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
497 |
427 |
$0.00 |
| J0665 |
Injection, bupivicaine, not otherwise specified, 0.5 mg |
168 |
141 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
109 |
92 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
36 |
28 |
$0.00 |