| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15 |
13 |
$5K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12 |
12 |
$4K |
| 80053 |
Comprehensive metabolic panel |
51 |
40 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
15 |
13 |
$17.08 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
12 |
$8.54 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
91 |
67 |
$0.00 |
| 81001 |
|
13 |
12 |
$0.00 |
| 84484 |
|
15 |
12 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
21 |
12 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15 |
12 |
$0.00 |