| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15 |
15 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
23 |
20 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
62 |
57 |
$0.00 |
| 0250 |
|
25 |
24 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
20 |
17 |
$0.00 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
16 |
14 |
$0.00 |
| 0301 |
|
19 |
19 |
$0.00 |
| 87081 |
|
13 |
13 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13 |
13 |
$0.00 |
| 0710 |
|
18 |
18 |
$0.00 |
| 83690 |
|
17 |
17 |
$0.00 |
| 0305 |
|
22 |
22 |
$0.00 |
| J3490 |
Unclassified drugs |
27 |
24 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
25 |
$0.00 |
| 84484 |
|
12 |
12 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
13 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
75 |
69 |
$0.00 |
| 81001 |
|
64 |
63 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
14 |
14 |
$0.00 |
| 99221 |
|
219 |
204 |
$0.00 |
| 0450 |
Emergency room services |
15 |
15 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
19 |
17 |
$0.00 |
| 0121 |
|
18 |
18 |
$0.00 |
| 80306 |
|
17 |
15 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
23 |
23 |
$0.00 |
| 81025 |
|
27 |
27 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
110 |
101 |
$0.00 |
| 0730 |
|
12 |
12 |
$0.00 |
| 0360 |
|
25 |
23 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
25 |
25 |
$0.00 |
| 0300 |
|
16 |
15 |
$0.00 |