| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
678 |
672 |
$128K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
861 |
858 |
$109K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
54 |
54 |
$15K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
341 |
341 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
817 |
807 |
$8K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
93 |
50 |
$6K |
| 80053 |
Comprehensive metabolic panel |
750 |
740 |
$5K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
119 |
117 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
184 |
184 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
866 |
839 |
$2K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
29 |
29 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
181 |
169 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$1K |
| 87400 |
|
96 |
56 |
$911.94 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
26 |
26 |
$856.32 |
| 84484 |
|
26 |
17 |
$747.36 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
41 |
41 |
$532.64 |
| 83690 |
|
56 |
56 |
$504.14 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
12 |
12 |
$500.48 |
| 84703 |
|
26 |
25 |
$251.64 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
17 |
13 |
$237.88 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
25 |
$229.04 |
| 83605 |
|
12 |
12 |
$178.62 |
| 81001 |
|
112 |
111 |
$174.90 |
| 83735 |
|
24 |
24 |
$150.00 |
| 81003 |
|
85 |
84 |
$105.39 |
| 71045 |
Radiologic examination, chest; single view |
16 |
16 |
$44.72 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
108 |
105 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
24 |
24 |
$0.00 |