| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,365 |
2,200 |
$125K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
770 |
676 |
$117K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
51 |
50 |
$69K |
| G0378 |
Hospital observation service, per hour |
197 |
141 |
$30K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
431 |
417 |
$24K |
| 80053 |
Comprehensive metabolic panel |
1,430 |
1,190 |
$11K |
| G0379 |
Direct admission of patient for hospital observation care |
151 |
101 |
$11K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
327 |
259 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
554 |
368 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
277 |
264 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,202 |
1,058 |
$7K |
| 59025 |
Fetal non-stress test |
72 |
53 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
116 |
105 |
$2K |
| 81001 |
|
715 |
651 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
122 |
110 |
$1K |
| 85027 |
|
265 |
216 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
16 |
14 |
$1K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
126 |
116 |
$515.89 |
| 87420 |
|
24 |
24 |
$382.46 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
45 |
41 |
$358.83 |
| 84484 |
|
60 |
38 |
$246.44 |
| 36415 |
Collection of venous blood by venipuncture |
2,620 |
2,183 |
$152.24 |
| 85610 |
|
51 |
49 |
$137.37 |
| 85730 |
|
24 |
24 |
$125.79 |
| 80306 |
|
14 |
12 |
$107.00 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
28 |
26 |
$100.30 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13 |
13 |
$58.46 |
| 84703 |
|
12 |
12 |
$50.88 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
13 |
$26.83 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15 |
15 |
$6.54 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
46 |
46 |
$4.80 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
13 |
13 |
$3.66 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
20 |
20 |
$2.88 |
| A9270 |
Non-covered item or service |
53 |
43 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
14 |
$0.00 |