| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
14 |
14 |
$522.37 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
54 |
51 |
$497.53 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
27 |
26 |
$405.07 |
| 80053 |
Comprehensive metabolic panel |
108 |
99 |
$308.96 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
99 |
50 |
$273.90 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
14 |
13 |
$243.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
116 |
107 |
$224.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
52 |
50 |
$128.70 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
22 |
21 |
$91.90 |
| 84484 |
|
29 |
17 |
$87.60 |
| 87081 |
|
26 |
26 |
$75.76 |
| 81025 |
|
25 |
23 |
$63.49 |
| 71046 |
Radiologic examination, chest; 2 views |
17 |
17 |
$50.11 |
| 81001 |
|
58 |
55 |
$42.70 |
| 80061 |
Lipid panel |
15 |
15 |
$36.32 |
| 82553 |
|
13 |
12 |
$36.23 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
17 |
17 |
$34.59 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15 |
15 |
$27.74 |
| 81003 |
|
19 |
19 |
$21.60 |
| 71045 |
Radiologic examination, chest; single view |
17 |
17 |
$20.54 |
| 83735 |
|
15 |
14 |
$11.50 |
| 82150 |
|
17 |
16 |
$9.26 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
38 |
32 |
$0.57 |
| 36415 |
Collection of venous blood by venipuncture |
42 |
38 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
19 |
19 |
$0.00 |