| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 29848 |
|
12 |
12 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
150 |
149 |
$7K |
| 62323 |
|
15 |
15 |
$6K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
18 |
17 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
133 |
132 |
$3K |
| 80061 |
Lipid panel |
100 |
100 |
$1K |
| 80053 |
Comprehensive metabolic panel |
123 |
123 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
124 |
124 |
$856.84 |
| 36415 |
Collection of venous blood by venipuncture |
122 |
122 |
$522.18 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
16 |
16 |
$421.28 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
329 |
328 |
$220.12 |
| 72100 |
|
12 |
12 |
$162.14 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$112.32 |
| 86900 |
|
24 |
24 |
$78.14 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
284 |
283 |
$25.15 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
132 |
131 |
$7.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
57 |
57 |
$0.12 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
188 |
188 |
$0.00 |
| J3490 |
Unclassified drugs |
120 |
119 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
177 |
176 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
620 |
618 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
336 |
336 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
244 |
244 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
16 |
16 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
41 |
41 |
$0.00 |