| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
10,178 |
9,700 |
$666K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
569 |
390 |
$323K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
6,410 |
6,191 |
$288K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
2,497 |
2,102 |
$135K |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,890 |
1,315 |
$116K |
| 80053 |
Comprehensive metabolic panel |
12,000 |
10,947 |
$107K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
1,257 |
1,228 |
$83K |
| 62323 |
|
360 |
344 |
$81K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
506 |
488 |
$73K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
2,883 |
2,728 |
$65K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,629 |
723 |
$61K |
| 80050 |
General health panel |
1,260 |
1,215 |
$56K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12,492 |
11,082 |
$55K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,473 |
1,427 |
$53K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
682 |
655 |
$40K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,228 |
5,825 |
$38K |
| 70450 |
Computed tomography, head or brain; without contrast material |
639 |
612 |
$30K |
| 80061 |
Lipid panel |
2,105 |
2,057 |
$29K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,428 |
3,058 |
$24K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
343 |
329 |
$24K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,304 |
1,257 |
$23K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
456 |
447 |
$19K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
84 |
83 |
$18K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,291 |
1,150 |
$18K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,319 |
1,279 |
$17K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
234 |
232 |
$17K |
| 84484 |
|
2,355 |
2,073 |
$16K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
208 |
206 |
$15K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
426 |
412 |
$15K |
| 71046 |
Radiologic examination, chest; 2 views |
1,224 |
1,188 |
$15K |
| 82553 |
|
2,202 |
1,983 |
$14K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
936 |
800 |
$14K |
| 84439 |
|
2,073 |
1,992 |
$14K |
| G0378 |
Hospital observation service, per hour |
34 |
32 |
$13K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
115 |
113 |
$12K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
524 |
371 |
$12K |
| 85730 |
|
2,221 |
2,084 |
$11K |
| 81001 |
|
4,261 |
4,008 |
$10K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,531 |
1,495 |
$9K |
| 83735 |
|
1,608 |
1,449 |
$9K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
154 |
150 |
$9K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
250 |
242 |
$8K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
47 |
45 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
1,392 |
1,318 |
$8K |
| 93971 |
|
135 |
133 |
$8K |
| 87040 |
|
739 |
644 |
$8K |
| 80320 |
|
669 |
607 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
7,476 |
6,138 |
$7K |
| 85610 |
|
2,628 |
2,386 |
$7K |
| 83605 |
|
1,184 |
1,084 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
974 |
868 |
$7K |
| 83690 |
|
1,523 |
1,392 |
$6K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
42 |
41 |
$6K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
29 |
29 |
$5K |
| 82150 |
|
1,311 |
1,196 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
464 |
405 |
$5K |
| 82805 |
|
182 |
168 |
$5K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
13 |
13 |
$5K |
| 83880 |
|
258 |
241 |
$4K |
| 82607 |
|
361 |
350 |
$4K |
| 87186 |
|
621 |
568 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
208 |
206 |
$4K |
| 87077 |
|
676 |
614 |
$4K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
283 |
209 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
17 |
12 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
853 |
800 |
$4K |
| 86003 |
|
13 |
12 |
$3K |
| 85027 |
|
580 |
508 |
$3K |
| 73564 |
|
180 |
179 |
$3K |
| 85379 |
|
387 |
377 |
$3K |
| 73610 |
|
185 |
180 |
$3K |
| 93017 |
|
98 |
96 |
$3K |
| 96376 |
|
288 |
197 |
$3K |
| 95886 |
|
74 |
49 |
$3K |
| 82728 |
|
231 |
222 |
$3K |
| 86618 |
|
93 |
91 |
$2K |
| 72110 |
|
107 |
104 |
$2K |
| 81003 |
|
823 |
778 |
$2K |
| 82043 |
|
272 |
265 |
$2K |
| 74018 |
|
176 |
171 |
$2K |
| 87081 |
|
398 |
390 |
$2K |
| 71250 |
|
39 |
37 |
$2K |
| 76377 |
|
275 |
266 |
$2K |
| 73030 |
|
139 |
134 |
$2K |
| 83540 |
|
209 |
200 |
$2K |
| 85652 |
|
638 |
595 |
$2K |
| 73630 |
|
192 |
185 |
$2K |
| 86803 |
|
98 |
97 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
160 |
151 |
$2K |
| 36600 |
|
183 |
168 |
$1K |
| 84146 |
|
68 |
67 |
$1K |
| 80076 |
|
170 |
159 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
28 |
28 |
$1K |
| 87070 |
|
285 |
257 |
$1K |
| 85007 |
|
416 |
352 |
$1K |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
45 |
43 |
$1K |
| 87340 |
|
92 |
90 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
17 |
$1K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
61 |
59 |
$1K |
| 86038 |
|
78 |
78 |
$1K |
| 76536 |
|
24 |
24 |
$1K |
| 84481 |
|
46 |
40 |
$1K |
| G0399 |
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation |
12 |
12 |
$998.12 |
| 90715 |
|
78 |
77 |
$982.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
168 |
165 |
$943.58 |
| 82570 |
|
139 |
132 |
$882.80 |
| 87205 |
|
283 |
254 |
$865.66 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
90 |
67 |
$864.04 |
| 73502 |
|
55 |
54 |
$863.14 |
| 81025 |
|
379 |
347 |
$846.08 |
| 83615 |
|
129 |
86 |
$837.60 |
| 83550 |
|
170 |
161 |
$834.68 |
| 70486 |
|
12 |
12 |
$771.14 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
15 |
14 |
$730.08 |
| 76830 |
Ultrasound, transvaginal |
15 |
15 |
$730.08 |
| 73130 |
|
66 |
64 |
$708.38 |
| 86140 |
|
268 |
239 |
$700.20 |
| 87339 |
|
108 |
106 |
$689.67 |
| 86308 |
|
100 |
97 |
$680.70 |
| 86255 |
|
14 |
12 |
$608.47 |
| 76770 |
|
13 |
13 |
$591.08 |
| 96367 |
|
23 |
12 |
$579.23 |
| 84100 |
|
93 |
67 |
$565.17 |
| 87807 |
|
46 |
46 |
$560.74 |
| 84550 |
|
93 |
69 |
$551.47 |
| 82746 |
|
46 |
45 |
$512.40 |
| 76642 |
|
15 |
15 |
$410.63 |
| 73110 |
|
43 |
43 |
$407.64 |
| 84703 |
|
41 |
40 |
$394.58 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
14 |
14 |
$394.20 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
89 |
79 |
$382.66 |
| 87806 |
|
13 |
13 |
$378.85 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
156 |
40 |
$373.80 |
| 86706 |
|
28 |
27 |
$365.80 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,771 |
1,523 |
$349.99 |
| 86885 |
|
78 |
69 |
$338.00 |
| J2704 |
Injection, propofol, 10 mg |
1,971 |
1,809 |
$334.62 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
16 |
16 |
$326.57 |
| 94010 |
|
46 |
43 |
$321.00 |
| 82248 |
|
64 |
52 |
$313.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
14 |
$306.60 |
| 82565 |
|
55 |
43 |
$273.24 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
294 |
213 |
$259.65 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
14 |
14 |
$250.10 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$248.34 |
| 80143 |
|
69 |
65 |
$247.96 |
| 86431 |
|
31 |
31 |
$243.46 |
| 82550 |
|
41 |
40 |
$237.30 |
| 82785 |
|
12 |
12 |
$232.76 |
| 83516 |
|
82 |
59 |
$232.36 |
| 86704 |
|
14 |
14 |
$216.75 |
| 86708 |
|
14 |
14 |
$216.00 |
| 86901 |
|
72 |
62 |
$192.05 |
| 36591 |
|
117 |
51 |
$191.57 |
| 86900 |
|
73 |
62 |
$189.62 |
| 80299 |
|
15 |
14 |
$188.98 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
184 |
176 |
$188.77 |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
113 |
95 |
$183.60 |
| 80179 |
|
54 |
50 |
$174.36 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,675 |
1,508 |
$173.53 |
| 51702 |
|
12 |
12 |
$145.80 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,712 |
2,416 |
$121.94 |
| 82977 |
|
12 |
12 |
$114.68 |
| 84480 |
|
12 |
12 |
$108.40 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
1,736 |
1,598 |
$107.62 |
| 73080 |
|
13 |
12 |
$103.76 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
197 |
181 |
$92.17 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
147 |
110 |
$88.09 |
| 97161 |
|
24 |
24 |
$73.15 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
906 |
828 |
$63.63 |
| 84520 |
|
13 |
12 |
$61.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
12 |
$59.50 |
| 88304 |
|
24 |
24 |
$52.07 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
17 |
16 |
$50.76 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
413 |
388 |
$35.32 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
76 |
55 |
$33.96 |
| J1644 |
Injection, heparin sodium, per 1000 units |
164 |
90 |
$17.13 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
290 |
255 |
$16.10 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
14 |
13 |
$13.68 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
894 |
831 |
$13.55 |
| J2060 |
Injection, lorazepam, 2 mg |
48 |
42 |
$10.33 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
118 |
89 |
$6.10 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
924 |
845 |
$5.65 |
| J7643 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
72 |
54 |
$0.00 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
18 |
15 |
$0.00 |
| 3048F |
|
333 |
329 |
$0.00 |
| 3044F |
|
108 |
105 |
$0.00 |
| 3049F |
|
328 |
320 |
$0.00 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
26 |
26 |
$0.00 |