| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,610 |
4,148 |
$395K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,949 |
3,717 |
$321K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
3,279 |
2,964 |
$288K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,094 |
958 |
$146K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
740 |
663 |
$72K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
711 |
680 |
$50K |
| 80053 |
Comprehensive metabolic panel |
3,202 |
2,838 |
$48K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
326 |
253 |
$39K |
| 70450 |
Computed tomography, head or brain; without contrast material |
258 |
227 |
$39K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
199 |
183 |
$30K |
| D7140 |
Extraction, erupted tooth or exposed root |
428 |
166 |
$22K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,085 |
884 |
$20K |
| 83605 |
|
781 |
649 |
$11K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
40 |
39 |
$10K |
| 84484 |
|
634 |
530 |
$8K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
152 |
112 |
$8K |
| G0378 |
Hospital observation service, per hour |
126 |
69 |
$7K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
71 |
61 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
397 |
328 |
$5K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
26 |
24 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
93 |
65 |
$5K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
339 |
274 |
$5K |
| 80061 |
Lipid panel |
488 |
444 |
$4K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
291 |
271 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
202 |
194 |
$4K |
| D1110 |
Prophylaxis - adult |
104 |
103 |
$3K |
| 88142 |
|
202 |
191 |
$2K |
| D0330 |
Panoramic radiographic image |
54 |
53 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
115 |
102 |
$2K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
81 |
77 |
$2K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
25 |
24 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
53 |
50 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
48 |
48 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
261 |
246 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,510 |
3,084 |
$1K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,338 |
1,198 |
$1K |
| 83880 |
|
114 |
99 |
$1K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
19 |
12 |
$1K |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
80 |
73 |
$926.75 |
| D0272 |
Bitewings - two radiographic images |
97 |
97 |
$920.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,304 |
2,614 |
$841.80 |
| 71046 |
Radiologic examination, chest; 2 views |
648 |
597 |
$819.19 |
| D0120 |
Periodic oral evaluation - established patient |
52 |
51 |
$804.84 |
| 85379 |
|
28 |
28 |
$591.71 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
687 |
643 |
$487.35 |
| 85027 |
|
195 |
172 |
$380.63 |
| 81025 |
|
1,250 |
1,151 |
$371.86 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
519 |
465 |
$350.27 |
| 71045 |
Radiologic examination, chest; single view |
273 |
244 |
$339.38 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
662 |
583 |
$320.22 |
| 81001 |
|
1,866 |
1,691 |
$307.74 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
814 |
431 |
$280.81 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,142 |
1,012 |
$279.90 |
| 87590 |
|
17 |
14 |
$278.35 |
| 82553 |
|
31 |
28 |
$267.42 |
| 84443 |
Thyroid stimulating hormone (TSH) |
282 |
260 |
$264.35 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$240.00 |
| 84703 |
|
172 |
166 |
$224.10 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$195.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,119 |
1,015 |
$189.24 |
| 83690 |
|
531 |
481 |
$175.86 |
| 83735 |
|
162 |
140 |
$86.58 |
| 81003 |
|
588 |
533 |
$63.21 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
53 |
50 |
$32.14 |
| 85730 |
|
191 |
173 |
$28.38 |
| 85610 |
|
353 |
315 |
$28.20 |
| 82150 |
|
125 |
116 |
$28.16 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
775 |
691 |
$24.75 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
526 |
415 |
$19.58 |
| 87430 |
|
246 |
235 |
$10.85 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
183 |
159 |
$8.94 |
| 87081 |
|
45 |
45 |
$8.05 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
45 |
$8.05 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
887 |
779 |
$5.98 |
| 81002 |
|
134 |
115 |
$4.53 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
285 |
242 |
$2.68 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
100 |
48 |
$2.64 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
35 |
28 |
$2.30 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
58 |
44 |
$1.63 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
141 |
123 |
$1.15 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
106 |
90 |
$0.49 |
| 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 |
27 |
26 |
$0.06 |
| J2704 |
Injection, propofol, 10 mg |
275 |
209 |
$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 |
70 |
62 |
$0.00 |
| 82550 |
|
88 |
82 |
$0.00 |
| 74022 |
|
19 |
19 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
26 |
$0.00 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
16 |
12 |
$0.00 |
| 85007 |
|
13 |
12 |
$0.00 |
| 87186 |
|
44 |
37 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
166 |
134 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
47 |
40 |
$0.00 |
| 73562 |
|
15 |
12 |
$0.00 |