| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,622 |
4,267 |
$158K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,363 |
2,160 |
$71K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,936 |
2,735 |
$36K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
621 |
599 |
$26K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
544 |
531 |
$19K |
| 80053 |
Comprehensive metabolic panel |
2,000 |
1,817 |
$18K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,283 |
2,062 |
$17K |
| 86403 |
|
1,032 |
993 |
$9K |
| 70450 |
Computed tomography, head or brain; without contrast material |
75 |
67 |
$5K |
| 81000 |
|
637 |
603 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
44 |
37 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
238 |
210 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
18 |
13 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
139 |
128 |
$1K |
| 81001 |
|
189 |
171 |
$692.98 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
42 |
39 |
$386.52 |
| 71045 |
Radiologic examination, chest; single view |
107 |
91 |
$250.52 |
| 84484 |
|
28 |
25 |
$123.07 |
| 82553 |
|
14 |
12 |
$119.07 |
| 82550 |
|
27 |
24 |
$112.92 |
| 81025 |
|
30 |
30 |
$111.28 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
226 |
215 |
$104.57 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,156 |
921 |
$32.17 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12 |
12 |
$10.66 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
14 |
$4.95 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18 |
17 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
54 |
40 |
$0.00 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
50 |
48 |
$0.00 |