| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
656 |
617 |
$25K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
397 |
378 |
$14K |
| 80053 |
Comprehensive metabolic panel |
1,144 |
1,026 |
$8K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,426 |
1,272 |
$4K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
178 |
159 |
$3K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
34 |
33 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
122 |
108 |
$829.92 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
49 |
43 |
$750.98 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
51 |
51 |
$725.81 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
78 |
62 |
$550.62 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
45 |
36 |
$432.94 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
14 |
14 |
$386.87 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12 |
12 |
$353.43 |
| 93296 |
|
95 |
89 |
$350.54 |
| 84484 |
|
40 |
29 |
$292.22 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
13 |
13 |
$283.03 |
| 80061 |
Lipid panel |
25 |
24 |
$262.38 |
| 84443 |
Thyroid stimulating hormone (TSH) |
27 |
25 |
$257.53 |
| 84703 |
|
27 |
25 |
$226.40 |
| 71045 |
Radiologic examination, chest; single view |
28 |
26 |
$177.17 |
| 85610 |
|
50 |
39 |
$132.01 |
| 81001 |
|
53 |
47 |
$93.50 |
| 83735 |
|
21 |
13 |
$84.56 |
| 71046 |
Radiologic examination, chest; 2 views |
17 |
15 |
$69.90 |
| 83690 |
|
13 |
12 |
$41.00 |
| 85730 |
|
20 |
18 |
$39.60 |
| 36415 |
Collection of venous blood by venipuncture |
919 |
829 |
$30.50 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
47 |
47 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
59 |
57 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
16 |
16 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
17 |
17 |
$0.00 |
| A9270 |
Non-covered item or service |
75 |
60 |
$0.00 |