| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
347 |
337 |
$100K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
29 |
29 |
$9K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
26 |
25 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$4K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
59 |
57 |
$71.89 |
| 80053 |
Comprehensive metabolic panel |
126 |
119 |
$65.28 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
53 |
53 |
$51.76 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
62 |
60 |
$50.72 |
| 85027 |
|
134 |
127 |
$50.30 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
47 |
31 |
$39.68 |
| 81001 |
|
55 |
54 |
$14.64 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
13 |
$13.32 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
19 |
19 |
$0.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
305 |
145 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
17 |
17 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
17 |
17 |
$0.00 |
| 85610 |
|
30 |
29 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
13 |
13 |
$0.00 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$0.00 |
| 84703 |
|
34 |
33 |
$0.00 |
| 84484 |
|
29 |
29 |
$0.00 |
| 87430 |
|
12 |
12 |
$0.00 |
| 87486 |
|
17 |
17 |
$0.00 |
| 82077 |
|
12 |
12 |
$0.00 |
| 83735 |
|
26 |
26 |
$0.00 |
| 83880 |
|
31 |
30 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
59 |
58 |
$0.00 |
| 83690 |
|
45 |
43 |
$0.00 |
| 87581 |
|
17 |
17 |
$0.00 |