| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
28,016 |
26,206 |
$3.63M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
20,279 |
19,172 |
$2.05M |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
6,369 |
5,876 |
$947K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,395 |
1,282 |
$310K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
7,418 |
6,938 |
$259K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
568 |
527 |
$235K |
| 80053 |
Comprehensive metabolic panel |
21,309 |
19,316 |
$181K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
24,537 |
21,989 |
$168K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
75 |
66 |
$167K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
2,407 |
2,189 |
$167K |
| J3490 |
Unclassified drugs |
11,238 |
6,085 |
$114K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,754 |
3,343 |
$111K |
| 71045 |
Radiologic examination, chest; single view |
2,440 |
2,226 |
$90K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,856 |
1,700 |
$77K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
84 |
81 |
$62K |
| D0220 |
Intraoral - periapical first radiographic image |
333 |
322 |
$61K |
| D0230 |
Intraoral - periapical each additional radiographic image |
346 |
322 |
$60K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,012 |
798 |
$55K |
| D0240 |
|
265 |
258 |
$45K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
226 |
220 |
$38K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
586 |
490 |
$35K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
26 |
26 |
$32K |
| 97597 |
|
959 |
531 |
$28K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
58 |
57 |
$28K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
552 |
337 |
$27K |
| 70450 |
Computed tomography, head or brain; without contrast material |
186 |
170 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,327 |
2,106 |
$25K |
| 84484 |
|
2,533 |
2,186 |
$22K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,571 |
1,231 |
$22K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,132 |
3,729 |
$21K |
| D7140 |
Extraction, erupted tooth or exposed root |
192 |
175 |
$21K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
73 |
66 |
$19K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,797 |
2,589 |
$17K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
143 |
102 |
$16K |
| 81001 |
|
4,379 |
4,050 |
$14K |
| D3221 |
|
208 |
200 |
$13K |
| 87631 |
|
151 |
148 |
$12K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
233 |
230 |
$11K |
| 83690 |
|
1,586 |
1,485 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
809 |
746 |
$10K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
27 |
25 |
$10K |
| 81025 |
|
1,208 |
1,101 |
$10K |
| 87430 |
|
593 |
567 |
$9K |
| 86850 |
|
653 |
610 |
$9K |
| 74018 |
|
196 |
188 |
$9K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
205 |
199 |
$8K |
| 87807 |
|
450 |
425 |
$7K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
13 |
13 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
277 |
243 |
$6K |
| 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 |
147 |
121 |
$6K |
| A9270 |
Non-covered item or service |
38,645 |
19,794 |
$6K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
56 |
46 |
$5K |
| J7050 |
Infusion, normal saline solution, 250 cc |
1,197 |
361 |
$5K |
| D1120 |
Prophylaxis - child |
30 |
29 |
$5K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,341 |
1,266 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
111 |
101 |
$4K |
| 87081 |
|
540 |
515 |
$4K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,439 |
1,337 |
$4K |
| D2934 |
|
29 |
26 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
2,055 |
1,846 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
595 |
568 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
53 |
51 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,791 |
1,668 |
$3K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
70 |
28 |
$3K |
| 81003 |
|
1,509 |
1,432 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
16 |
15 |
$3K |
| 86900 |
|
511 |
481 |
$3K |
| D2940 |
|
14 |
14 |
$3K |
| 83735 |
|
376 |
328 |
$2K |
| 87088 |
|
311 |
297 |
$2K |
| 76830 |
Ultrasound, transvaginal |
14 |
13 |
$2K |
| 83605 |
|
214 |
200 |
$2K |
| G0378 |
Hospital observation service, per hour |
30 |
24 |
$2K |
| 86901 |
|
511 |
481 |
$2K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,163 |
1,105 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
789 |
754 |
$2K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
14 |
12 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
108 |
96 |
$2K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
171 |
164 |
$2K |
| 85027 |
|
288 |
271 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
236 |
152 |
$2K |
| J0735 |
Injection, clonidine hydrochloride, 1 mg |
85 |
84 |
$1K |
| J2704 |
Injection, propofol, 10 mg |
257 |
219 |
$1K |
| 71250 |
|
13 |
13 |
$1K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
119 |
112 |
$1K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
27 |
25 |
$1K |
| 84466 |
|
82 |
80 |
$1K |
| 82728 |
|
73 |
70 |
$974.20 |
| 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 |
1,316 |
1,235 |
$750.94 |
| 0012A |
|
12 |
12 |
$715.00 |
| 84439 |
|
63 |
55 |
$560.02 |
| 83540 |
|
82 |
80 |
$543.80 |
| 84702 |
|
47 |
44 |
$537.89 |
| 0011A |
|
14 |
14 |
$520.00 |
| A4217 |
Sterile water/saline, 500 ml |
70 |
67 |
$440.37 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
360 |
321 |
$425.46 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
80 |
67 |
$302.05 |
| 87420 |
|
14 |
14 |
$262.50 |
| 85379 |
|
26 |
25 |
$202.44 |
| J2003 |
Injection, lidocaine hydrochloride, 1 mg |
38 |
25 |
$111.40 |
| J1790 |
Injection, droperidol, up to 5 mg |
12 |
12 |
$100.10 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
44 |
38 |
$45.57 |
| J2004 |
Injection, lidocaine hcl with epinephrine, 1 mg |
13 |
13 |
$38.80 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
31 |
25 |
$20.91 |
| J2060 |
Injection, lorazepam, 2 mg |
15 |
12 |
$12.37 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
356 |
327 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
75 |
69 |
$0.00 |
| 91301 |
|
13 |
13 |
$0.00 |