| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,385 |
2,265 |
$99K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
902 |
835 |
$40K |
| 87631 |
|
102 |
94 |
$10K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
70 |
68 |
$6K |
| 80053 |
Comprehensive metabolic panel |
290 |
257 |
$3K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
107 |
89 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
59 |
42 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
39 |
38 |
$2K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
46 |
44 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
284 |
253 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
16 |
14 |
$949.31 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
58 |
43 |
$877.85 |
| 71046 |
Radiologic examination, chest; 2 views |
61 |
58 |
$626.25 |
| 81025 |
|
80 |
72 |
$618.39 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
43 |
37 |
$583.07 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
28 |
25 |
$504.93 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17 |
16 |
$465.42 |
| 81001 |
|
79 |
69 |
$308.13 |
| 85027 |
|
40 |
38 |
$272.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
31 |
$242.82 |
| 84484 |
|
19 |
15 |
$167.10 |
| 83690 |
|
26 |
20 |
$163.36 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
15 |
14 |
$123.78 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
66 |
57 |
$123.40 |
| 87081 |
|
14 |
14 |
$105.71 |
| 71045 |
Radiologic examination, chest; single view |
20 |
17 |
$83.87 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
98 |
75 |
$53.78 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
19 |
16 |
$29.37 |
| 81003 |
|
25 |
21 |
$17.69 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
17 |
12 |
$9.57 |
| A9270 |
Non-covered item or service |
49 |
26 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
107 |
83 |
$0.00 |