| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4011 |
State-specific procedure code |
7,029 |
6,550 |
$2.56M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
3,194 |
2,721 |
$631K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
7,570 |
6,960 |
$454K |
| 80053 |
Comprehensive metabolic panel |
6,978 |
6,420 |
$404K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,212 |
2,061 |
$360K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
4,222 |
3,632 |
$208K |
| 81003 |
|
3,473 |
2,950 |
$187K |
| X4003 |
|
1,377 |
1,052 |
$150K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
343 |
287 |
$149K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
782 |
661 |
$88K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,099 |
1,012 |
$83K |
| J3490 |
Unclassified drugs |
489 |
424 |
$61K |
| 83605 |
|
1,181 |
1,040 |
$58K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
838 |
808 |
$53K |
| 81025 |
|
329 |
299 |
$52K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
485 |
441 |
$50K |
| 86900 |
|
501 |
463 |
$46K |
| 71045 |
Radiologic examination, chest; single view |
877 |
796 |
$44K |
| 86850 |
|
516 |
478 |
$39K |
| 86901 |
|
486 |
448 |
$36K |
| 59025 |
Fetal non-stress test |
187 |
125 |
$33K |
| 87428 |
|
1,030 |
1,009 |
$31K |
| 85027 |
|
210 |
194 |
$30K |
| 84484 |
|
747 |
637 |
$28K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
615 |
564 |
$28K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
133 |
99 |
$23K |
| 11721 |
|
3,039 |
1,842 |
$21K |
| 76818 |
|
228 |
126 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
737 |
728 |
$12K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
198 |
194 |
$11K |
| Q3014 |
Telehealth originating site facility fee |
652 |
640 |
$10K |
| 83690 |
|
185 |
174 |
$8K |
| 87660 |
|
647 |
628 |
$8K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
167 |
157 |
$7K |
| 81513 |
|
63 |
62 |
$7K |
| 81001 |
|
28 |
26 |
$6K |
| 87040 |
|
59 |
38 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
44 |
40 |
$6K |
| 87081 |
|
634 |
626 |
$5K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
120 |
119 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
108 |
107 |
$5K |
| 87480 |
|
351 |
341 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
14 |
12 |
$4K |
| 85610 |
|
114 |
103 |
$4K |
| 86787 |
|
65 |
63 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
12 |
12 |
$4K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
43 |
39 |
$3K |
| 76801 |
|
42 |
40 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
66 |
63 |
$3K |
| 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 |
174 |
173 |
$3K |
| 85730 |
|
64 |
55 |
$3K |
| 86803 |
|
65 |
63 |
$3K |
| 87510 |
|
216 |
210 |
$3K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
93 |
90 |
$3K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
52 |
51 |
$3K |
| 82550 |
|
41 |
39 |
$3K |
| 80081 |
|
38 |
38 |
$2K |
| 87807 |
|
134 |
130 |
$2K |
| 83735 |
|
660 |
597 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
141 |
139 |
$2K |
| 82950 |
|
95 |
93 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
149 |
130 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
12 |
$1K |
| 87015 |
|
24 |
24 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
12 |
12 |
$716.03 |
| 84702 |
|
15 |
14 |
$533.16 |
| 87481 |
|
12 |
12 |
$530.60 |
| 80061 |
Lipid panel |
41 |
40 |
$468.97 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
50 |
49 |
$347.30 |
| 36415 |
Collection of venous blood by venipuncture |
175 |
156 |
$312.20 |
| 83880 |
|
42 |
37 |
$226.16 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
32 |
30 |
$165.17 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14 |
14 |
$153.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
60 |
56 |
$57.51 |
| 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 |
25 |
25 |
$25.00 |
| A9270 |
Non-covered item or service |
142 |
91 |
$0.00 |