| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
923 |
884 |
$156K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,051 |
992 |
$108K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
280 |
271 |
$95K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
609 |
565 |
$51K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
590 |
450 |
$17K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
344 |
324 |
$15K |
| 71046 |
Radiologic examination, chest; 2 views |
352 |
342 |
$11K |
| 82947 |
|
488 |
401 |
$7K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
64 |
27 |
$7K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
26 |
26 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
28 |
27 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,608 |
1,411 |
$2K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
22 |
16 |
$2K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
24 |
24 |
$1K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
38 |
37 |
$915.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
64 |
64 |
$428.40 |
| A9270 |
Non-covered item or service |
1,142 |
987 |
$115.26 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
365 |
329 |
$29.05 |
| 84484 |
|
235 |
178 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
379 |
354 |
$0.00 |
| 82150 |
|
223 |
211 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
14 |
13 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
91 |
76 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,294 |
1,172 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
796 |
717 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
474 |
390 |
$0.00 |
| 84075 |
|
212 |
195 |
$0.00 |
| 81001 |
|
394 |
385 |
$0.00 |
| 83735 |
|
250 |
196 |
$0.00 |
| 85730 |
|
239 |
222 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
55 |
55 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
189 |
125 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
177 |
175 |
$0.00 |
| 83690 |
|
240 |
226 |
$0.00 |
| J3490 |
Unclassified drugs |
837 |
556 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
543 |
439 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
268 |
264 |
$0.00 |
| 80051 |
|
208 |
196 |
$0.00 |
| 85027 |
|
17 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
55 |
39 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
94 |
92 |
$0.00 |
| 83605 |
|
14 |
14 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
27 |
26 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
57 |
48 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
16 |
12 |
$0.00 |
| 82565 |
|
244 |
234 |
$0.00 |
| 84450 |
|
249 |
237 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
628 |
501 |
$0.00 |
| 84520 |
|
267 |
256 |
$0.00 |
| 90715 |
|
56 |
56 |
$0.00 |
| 84460 |
|
263 |
251 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
125 |
110 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,029 |
909 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
107 |
107 |
$0.00 |
| 81025 |
|
512 |
491 |
$0.00 |
| S5000 |
Prescription drug, generic |
126 |
100 |
$0.00 |
| 85610 |
|
267 |
250 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
78 |
70 |
$0.00 |
| 81003 |
|
208 |
206 |
$0.00 |
| 82247 |
|
249 |
238 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
25 |
24 |
$0.00 |
| 84100 |
|
207 |
174 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
14 |
13 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
17 |
17 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
12 |
12 |
$0.00 |