| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
821 |
636 |
$196K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,234 |
970 |
$169K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
324 |
212 |
$83K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
775 |
729 |
$53K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,074 |
344 |
$34K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
225 |
187 |
$22K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
329 |
299 |
$20K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
214 |
208 |
$18K |
| 80053 |
Comprehensive metabolic panel |
2,046 |
1,754 |
$17K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,239 |
1,886 |
$14K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
98 |
86 |
$10K |
| 84443 |
Thyroid stimulating hormone (TSH) |
737 |
713 |
$10K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
271 |
259 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,645 |
1,394 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
2,473 |
2,135 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
201 |
172 |
$5K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
71 |
15 |
$4K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
118 |
112 |
$4K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
159 |
51 |
$4K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
261 |
227 |
$4K |
| 81001 |
|
976 |
870 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
256 |
246 |
$3K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
35 |
27 |
$2K |
| 84703 |
|
250 |
235 |
$2K |
| 80061 |
Lipid panel |
195 |
194 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
267 |
242 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
54 |
54 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
254 |
249 |
$1K |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
111 |
82 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
191 |
166 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
185 |
158 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
172 |
155 |
$1K |
| 85610 |
|
270 |
208 |
$915.68 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
16 |
15 |
$765.85 |
| 84484 |
|
74 |
54 |
$754.25 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
53 |
$691.91 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
16 |
16 |
$623.99 |
| 81003 |
|
196 |
182 |
$564.94 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$540.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
31 |
25 |
$449.75 |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$430.30 |
| J2704 |
Injection, propofol, 10 mg |
47 |
41 |
$351.97 |
| 87070 |
|
41 |
39 |
$341.33 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
30 |
27 |
$335.87 |
| 80305 |
|
28 |
26 |
$319.10 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
25 |
$293.81 |
| J7050 |
Infusion, normal saline solution, 250 cc |
136 |
72 |
$292.98 |
| 83690 |
|
47 |
42 |
$290.29 |
| 84439 |
|
26 |
25 |
$213.62 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$195.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
25 |
25 |
$193.72 |
| 87430 |
|
13 |
13 |
$158.29 |
| 85027 |
|
24 |
24 |
$144.53 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
37 |
$114.85 |
| 87186 |
|
13 |
12 |
$96.00 |
| 87077 |
|
13 |
12 |
$89.70 |
| 86140 |
|
21 |
21 |
$78.70 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
43 |
41 |
$32.73 |
| A9270 |
Non-covered item or service |
77 |
25 |
$0.00 |