| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26,963 |
25,365 |
$6.90M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
32,841 |
31,172 |
$5.63M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60,877 |
57,538 |
$1.51M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
3,699 |
3,428 |
$1.43M |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
11,940 |
10,795 |
$1.42M |
| 96361 |
Intravenous infusion, hydration; each additional hour |
9,875 |
7,750 |
$1.11M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
7,834 |
6,845 |
$679K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
5,267 |
4,977 |
$573K |
| 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 |
6,196 |
5,797 |
$453K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
154 |
153 |
$277K |
| 59025 |
Fetal non-stress test |
1,962 |
1,161 |
$270K |
| 71046 |
Radiologic examination, chest; 2 views |
4,801 |
4,516 |
$264K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
7,721 |
6,635 |
$230K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
487 |
478 |
$155K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,485 |
1,475 |
$132K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,745 |
3,446 |
$129K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,761 |
3,458 |
$108K |
| 87081 |
|
15,551 |
14,965 |
$97K |
| 36415 |
Collection of venous blood by venipuncture |
35,164 |
30,504 |
$73K |
| 87806 |
|
2,755 |
2,633 |
$72K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,484 |
1,474 |
$72K |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,489 |
5,241 |
$71K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
6,107 |
5,881 |
$69K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
147 |
137 |
$61K |
| 47562 |
|
13 |
13 |
$60K |
| 80053 |
Comprehensive metabolic panel |
25,892 |
23,854 |
$58K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
568 |
541 |
$58K |
| 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 |
2,791 |
2,640 |
$55K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,776 |
1,584 |
$52K |
| 71045 |
Radiologic examination, chest; single view |
849 |
811 |
$49K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34,196 |
30,950 |
$49K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
865 |
344 |
$46K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,243 |
456 |
$43K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
335 |
323 |
$42K |
| 86803 |
|
3,455 |
3,303 |
$41K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
132 |
121 |
$39K |
| G0378 |
Hospital observation service, per hour |
1,095 |
965 |
$36K |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
43 |
39 |
$33K |
| 87340 |
|
3,429 |
3,285 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
340 |
204 |
$28K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
8,226 |
7,286 |
$28K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,532 |
1,450 |
$27K |
| 87631 |
|
470 |
442 |
$19K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
307 |
300 |
$19K |
| 86780 |
|
1,662 |
1,625 |
$18K |
| 76642 |
|
283 |
246 |
$18K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
168 |
119 |
$17K |
| 0353U |
|
1,182 |
1,133 |
$17K |
| 80076 |
|
1,548 |
1,493 |
$10K |
| 80061 |
Lipid panel |
913 |
890 |
$10K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
39 |
39 |
$10K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,984 |
3,326 |
$9K |
| 87634 |
|
1,120 |
1,062 |
$9K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
458 |
450 |
$9K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
95 |
90 |
$9K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
365 |
328 |
$9K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
111 |
40 |
$8K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,849 |
3,521 |
$8K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
6,981 |
6,118 |
$8K |
| 83655 |
|
722 |
707 |
$8K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
4,926 |
4,383 |
$7K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
69 |
62 |
$6K |
| 85027 |
|
2,599 |
2,199 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
129 |
122 |
$5K |
| 86592 |
|
973 |
926 |
$3K |
| 86480 |
|
62 |
60 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
30 |
30 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
29 |
27 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,149 |
1,047 |
$3K |
| J2785 |
Injection, regadenoson, 0.1 mg |
55 |
49 |
$3K |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
20 |
20 |
$3K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
134 |
12 |
$2K |
| 93296 |
|
118 |
112 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$2K |
| G0432 |
Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening |
174 |
163 |
$2K |
| 81015 |
|
4,451 |
4,149 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
647 |
602 |
$2K |
| 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 |
68 |
65 |
$2K |
| 87899 |
|
174 |
163 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33 |
12 |
$2K |
| 94010 |
|
2,449 |
2,337 |
$2K |
| 80055 |
|
44 |
41 |
$2K |
| 77066 |
Tomosynthesis, mammo |
13 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,612 |
1,492 |
$1K |
| 76830 |
Ultrasound, transvaginal |
16 |
15 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
912 |
881 |
$1K |
| 86140 |
|
5,212 |
4,874 |
$1K |
| 85018 |
|
466 |
461 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
178 |
172 |
$1K |
| 97535 |
Self-care/home management training, each 15 minutes |
21 |
12 |
$961.32 |
| 85007 |
|
650 |
596 |
$904.54 |
| 36416 |
|
120 |
90 |
$694.15 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
630 |
370 |
$624.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
97 |
94 |
$594.45 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
402 |
359 |
$549.86 |
| 87210 |
|
110 |
105 |
$526.88 |
| 87070 |
|
39 |
37 |
$521.61 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
307 |
264 |
$495.02 |
| 87077 |
|
115 |
93 |
$489.59 |
| 83690 |
|
4,343 |
4,012 |
$452.95 |
| 93017 |
|
59 |
54 |
$380.72 |
| 88304 |
|
87 |
82 |
$323.69 |
| J3490 |
Unclassified drugs |
49 |
30 |
$291.01 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
300 |
284 |
$248.45 |
| A9270 |
Non-covered item or service |
983 |
607 |
$237.92 |
| 84703 |
|
2,913 |
2,690 |
$237.51 |
| 84439 |
|
50 |
47 |
$170.26 |
| 87186 |
|
43 |
39 |
$148.67 |
| 86900 |
|
13 |
12 |
$146.85 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
219 |
165 |
$141.66 |
| 83735 |
|
97 |
91 |
$140.14 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
92 |
73 |
$125.61 |
| 76942 |
|
58 |
55 |
$113.61 |
| 81001 |
|
2,113 |
1,933 |
$105.09 |
| J0694 |
Injection, cefoxitin sodium, 1 gm |
32 |
16 |
$71.10 |
| 81002 |
|
15 |
13 |
$52.72 |
| 83880 |
|
25 |
24 |
$39.26 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
386 |
335 |
$39.00 |
| 81003 |
|
388 |
353 |
$37.61 |
| 84484 |
|
1,126 |
704 |
$25.07 |
| 86901 |
|
13 |
12 |
$23.90 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
212 |
181 |
$22.51 |
| 94729 |
|
77 |
74 |
$6.93 |
| J2710 |
Injection, neostigmine methylsulfate, up to 0.5 mg |
17 |
12 |
$3.60 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
456 |
421 |
$2.33 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
12 |
12 |
$0.75 |
| 84145 |
|
13 |
13 |
$0.00 |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
56 |
51 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
38 |
17 |
$0.00 |
| 80179 |
|
19 |
14 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
16 |
12 |
$0.00 |
| 81025 |
|
13 |
13 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
16 |
16 |
$0.00 |
| 80143 |
|
22 |
13 |
$0.00 |
| 83605 |
|
313 |
252 |
$0.00 |
| 96376 |
|
467 |
274 |
$0.00 |
| 87040 |
|
83 |
50 |
$0.00 |
| 99406 |
|
32 |
30 |
$0.00 |
| 82962 |
|
14 |
12 |
$0.00 |
| 83874 |
|
13 |
13 |
$0.00 |
| 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 |
13 |
13 |
$0.00 |
| 82553 |
|
13 |
13 |
$0.00 |
| 82550 |
|
13 |
13 |
$0.00 |
| 0352U |
|
17 |
17 |
$0.00 |
| 80320 |
|
20 |
12 |
$0.00 |