| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
908 |
582 |
$39K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,724 |
2,062 |
$38K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,026 |
766 |
$13K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,021 |
850 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
477 |
273 |
$8K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
46 |
43 |
$6K |
| 80053 |
Comprehensive metabolic panel |
3,463 |
2,699 |
$5K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
81 |
61 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,495 |
1,254 |
$4K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
66 |
56 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,515 |
2,634 |
$2K |
| 87400 |
|
264 |
191 |
$2K |
| J3490 |
Unclassified drugs |
1,826 |
755 |
$1K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
397 |
298 |
$1K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
160 |
37 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
4,357 |
3,286 |
$919.03 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
166 |
126 |
$475.11 |
| 80061 |
Lipid panel |
307 |
264 |
$426.02 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
159 |
121 |
$388.47 |
| 86140 |
|
355 |
280 |
$335.43 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
322 |
260 |
$292.55 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
19 |
17 |
$232.49 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
66 |
57 |
$209.13 |
| 71045 |
Radiologic examination, chest; single view |
59 |
51 |
$181.92 |
| 71046 |
Radiologic examination, chest; 2 views |
49 |
40 |
$169.87 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
68 |
53 |
$131.99 |
| 81001 |
|
263 |
222 |
$117.23 |
| 83690 |
|
47 |
39 |
$113.80 |
| 84443 |
Thyroid stimulating hormone (TSH) |
679 |
568 |
$105.24 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
67 |
63 |
$87.87 |
| 81003 |
|
347 |
296 |
$59.52 |
| 84484 |
|
74 |
62 |
$57.10 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
128 |
83 |
$55.17 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
34 |
$40.19 |
| 90688 |
|
20 |
19 |
$16.20 |
| 80305 |
|
19 |
12 |
$6.97 |
| 85027 |
|
67 |
59 |
$6.70 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
18 |
18 |
$0.22 |
| 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 |
18 |
13 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
26 |
24 |
$0.00 |
| 81015 |
|
60 |
38 |
$0.00 |
| A9270 |
Non-covered item or service |
557 |
233 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
12 |
12 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
39 |
24 |
$0.00 |