| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
8,716 |
7,457 |
$987K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
8,032 |
7,311 |
$883K |
| 70450 |
Computed tomography, head or brain; without contrast material |
499 |
431 |
$126K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
855 |
747 |
$100K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
276 |
244 |
$93K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
740 |
654 |
$86K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
192 |
172 |
$58K |
| G0378 |
Hospital observation service, per hour |
1,331 |
666 |
$58K |
| 80053 |
Comprehensive metabolic panel |
6,802 |
5,736 |
$36K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
697 |
309 |
$32K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
731 |
619 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,746 |
4,437 |
$10K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
15 |
14 |
$7K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
2,250 |
1,563 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
669 |
601 |
$5K |
| 87040 |
|
419 |
364 |
$5K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
3,254 |
2,811 |
$5K |
| 87807 |
|
937 |
899 |
$4K |
| 87070 |
|
1,703 |
1,599 |
$4K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
3,454 |
2,711 |
$3K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
180 |
154 |
$3K |
| 87275 |
|
4,389 |
4,116 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
2,310 |
2,053 |
$3K |
| 76801 |
|
423 |
311 |
$3K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
341 |
230 |
$3K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
209 |
189 |
$2K |
| 85027 |
|
8,136 |
6,618 |
$2K |
| 81025 |
|
1,372 |
1,271 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
280 |
251 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,143 |
930 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
169 |
151 |
$2K |
| 87276 |
|
4,389 |
4,114 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
647 |
499 |
$2K |
| 74022 |
|
37 |
33 |
$1K |
| 72131 |
|
13 |
13 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,682 |
1,270 |
$1K |
| 87480 |
|
157 |
143 |
$640.93 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
306 |
264 |
$498.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,809 |
1,705 |
$378.06 |
| 81001 |
|
3,000 |
2,692 |
$363.96 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,142 |
881 |
$332.36 |
| 72100 |
|
15 |
12 |
$210.72 |
| 83690 |
|
1,491 |
1,294 |
$208.68 |
| 85610 |
|
711 |
620 |
$181.03 |
| 85730 |
|
675 |
592 |
$181.03 |
| 76830 |
Ultrasound, transvaginal |
34 |
28 |
$142.10 |
| 87077 |
|
196 |
182 |
$131.04 |
| 84703 |
|
1,770 |
1,480 |
$126.76 |
| 84484 |
|
1,166 |
915 |
$122.43 |
| A9270 |
Non-covered item or service |
133 |
26 |
$93.79 |
| 71046 |
Radiologic examination, chest; 2 views |
392 |
345 |
$72.62 |
| 81003 |
|
1,168 |
1,013 |
$60.75 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
217 |
198 |
$40.12 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
160 |
143 |
$39.91 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
666 |
467 |
$21.08 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
779 |
700 |
$20.77 |
| 84702 |
|
583 |
417 |
$17.50 |
| 86140 |
|
234 |
205 |
$14.40 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
135 |
111 |
$5.10 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
380 |
269 |
$3.33 |
| 86900 |
|
750 |
649 |
$2.50 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
559 |
356 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
376 |
316 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
69 |
41 |
$0.00 |
| 85007 |
|
262 |
200 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
275 |
218 |
$0.00 |
| 74018 |
|
71 |
68 |
$0.00 |
| 87660 |
|
157 |
143 |
$0.00 |
| 73562 |
|
29 |
26 |
$0.00 |
| 73630 |
|
40 |
40 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
27 |
24 |
$0.00 |
| 73610 |
|
14 |
14 |
$0.00 |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
21 |
12 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
16 |
14 |
$0.00 |
| 80076 |
|
13 |
12 |
$0.00 |
| 86850 |
|
454 |
383 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
356 |
285 |
$0.00 |
| 86901 |
|
454 |
383 |
$0.00 |
| 83605 |
|
344 |
289 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
415 |
342 |
$0.00 |
| 83735 |
|
68 |
57 |
$0.00 |
| 87487 |
|
159 |
145 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
44 |
39 |
$0.00 |
| 82550 |
|
79 |
69 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
394 |
315 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
159 |
145 |
$0.00 |
| 99460 |
|
56 |
38 |
$0.00 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
92 |
91 |
$0.00 |
| 92650 |
|
1,210 |
895 |
$0.00 |
| 83880 |
|
108 |
91 |
$0.00 |
| 85379 |
|
130 |
119 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
27 |
26 |
$0.00 |
| 87510 |
|
157 |
143 |
$0.00 |
| 85651 |
|
51 |
42 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
148 |
119 |
$0.00 |
| J3490 |
Unclassified drugs |
76 |
66 |
$0.00 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
19 |
14 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
55 |
37 |
$0.00 |
| 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 |
15 |
12 |
$0.00 |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
16 |
12 |
$0.00 |