| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
7,279 |
7,082 |
$1.28M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,899 |
4,764 |
$551K |
| G0378 |
Hospital observation service, per hour |
379 |
355 |
$503K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
751 |
722 |
$151K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,099 |
1,081 |
$118K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,896 |
1,846 |
$113K |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,310 |
790 |
$102K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
351 |
344 |
$70K |
| 71045 |
Radiologic examination, chest; single view |
2,679 |
2,592 |
$57K |
| 80053 |
Comprehensive metabolic panel |
6,484 |
5,978 |
$52K |
| 70450 |
Computed tomography, head or brain; without contrast material |
490 |
464 |
$40K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
8,732 |
7,838 |
$35K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
728 |
688 |
$33K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
4,318 |
4,091 |
$29K |
| 80050 |
General health panel |
598 |
579 |
$23K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
681 |
672 |
$22K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,083 |
836 |
$21K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
839 |
819 |
$21K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
460 |
445 |
$20K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
834 |
815 |
$19K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
338 |
252 |
$16K |
| 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 |
194 |
188 |
$16K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
319 |
303 |
$14K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
597 |
195 |
$14K |
| 84484 |
|
1,991 |
1,845 |
$13K |
| 87625 |
|
276 |
270 |
$11K |
| 85730 |
|
2,314 |
2,198 |
$11K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
128 |
128 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
502 |
495 |
$11K |
| 83735 |
|
2,277 |
2,038 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,774 |
1,470 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
84 |
83 |
$8K |
| 84703 |
|
1,102 |
1,068 |
$8K |
| 80061 |
Lipid panel |
592 |
583 |
$8K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
42 |
42 |
$8K |
| 81001 |
|
3,807 |
3,679 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
440 |
425 |
$7K |
| 85610 |
|
2,739 |
2,579 |
$7K |
| 87481 |
|
760 |
444 |
$7K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,164 |
1,019 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
9,555 |
8,824 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
283 |
283 |
$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 |
214 |
201 |
$6K |
| 87480 |
|
207 |
204 |
$5K |
| 87660 |
|
208 |
205 |
$5K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
146 |
84 |
$5K |
| 81514 |
|
39 |
39 |
$5K |
| 83690 |
|
1,246 |
1,218 |
$4K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
109 |
108 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
116 |
116 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
423 |
345 |
$3K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
41 |
41 |
$3K |
| 76830 |
Ultrasound, transvaginal |
53 |
53 |
$3K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
432 |
417 |
$3K |
| 0002A |
|
55 |
55 |
$3K |
| J3490 |
Unclassified drugs |
712 |
350 |
$3K |
| 0001A |
|
54 |
54 |
$3K |
| 83605 |
|
412 |
379 |
$2K |
| A4657 |
Syringe, with or without needle, each |
549 |
539 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
54 |
54 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
334 |
327 |
$2K |
| 85378 |
|
309 |
295 |
$2K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
122 |
116 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
50 |
50 |
$2K |
| 84439 |
|
190 |
185 |
$2K |
| 93975 |
|
12 |
12 |
$2K |
| 87510 |
|
180 |
179 |
$1K |
| 82150 |
|
437 |
431 |
$1K |
| 87040 |
|
177 |
170 |
$1K |
| 80076 |
|
212 |
207 |
$1K |
| 93970 |
|
12 |
12 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
105 |
65 |
$1K |
| 0004A |
|
24 |
24 |
$1K |
| 87070 |
|
197 |
185 |
$966.08 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
25 |
25 |
$935.88 |
| 84702 |
|
59 |
54 |
$872.31 |
| 82607 |
|
70 |
69 |
$774.37 |
| 81025 |
|
311 |
297 |
$772.78 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
143 |
138 |
$742.84 |
| 73630 |
|
90 |
82 |
$713.09 |
| 76536 |
|
12 |
12 |
$680.12 |
| 87077 |
|
140 |
139 |
$625.65 |
| 82550 |
|
150 |
133 |
$606.68 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
1,273 |
969 |
$541.53 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
297 |
205 |
$539.29 |
| 86850 |
|
84 |
81 |
$502.19 |
| 73610 |
|
40 |
38 |
$466.18 |
| U0005 |
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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
185 |
179 |
$463.63 |
| 82077 |
|
39 |
38 |
$460.60 |
| 83540 |
|
61 |
57 |
$420.27 |
| 73564 |
|
32 |
27 |
$412.16 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
14 |
14 |
$411.57 |
| 87186 |
|
76 |
75 |
$407.39 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
2,758 |
2,120 |
$386.11 |
| 80143 |
|
31 |
30 |
$383.67 |
| 80179 |
|
31 |
30 |
$383.67 |
| 82728 |
|
43 |
41 |
$362.70 |
| 73130 |
|
41 |
38 |
$355.74 |
| 84100 |
|
57 |
40 |
$353.96 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,258 |
1,764 |
$348.97 |
| 86803 |
|
16 |
16 |
$345.61 |
| 82570 |
|
41 |
41 |
$310.16 |
| 86901 |
|
99 |
95 |
$292.22 |
| 86900 |
|
100 |
96 |
$288.81 |
| 83880 |
|
28 |
24 |
$285.71 |
| 87275 |
|
27 |
26 |
$263.88 |
| 83550 |
|
56 |
53 |
$227.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
38 |
$219.30 |
| 73030 |
|
13 |
12 |
$208.96 |
| 86592 |
|
48 |
46 |
$201.72 |
| 87276 |
|
26 |
25 |
$187.70 |
| 87205 |
|
58 |
55 |
$185.15 |
| 86140 |
|
64 |
56 |
$184.05 |
| 85651 |
|
63 |
60 |
$183.26 |
| 82746 |
|
12 |
12 |
$73.22 |
| 87081 |
|
137 |
130 |
$47.64 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
330 |
277 |
$36.72 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
548 |
478 |
$28.81 |
| J2704 |
Injection, propofol, 10 mg |
250 |
200 |
$28.39 |
| A9270 |
Non-covered item or service |
1,427 |
1,356 |
$17.03 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
72 |
65 |
$9.71 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
296 |
263 |
$5.94 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
112 |
98 |
$3.53 |
| A4615 |
Cannula, nasal |
16 |
15 |
$0.88 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
43 |
42 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
76 |
67 |
$0.00 |
| J2919 |
Injection, methylprednisolone sodium succinate, 5 mg |
49 |
44 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
40 |
40 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
119 |
67 |
$0.00 |
| J2765 |
Injection, metoclopramide hcl, up to 10 mg |
15 |
12 |
$0.00 |
| J2060 |
Injection, lorazepam, 2 mg |
14 |
14 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
13 |
13 |
$0.00 |