| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87631 |
|
127 |
121 |
$16K |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
279 |
271 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
291 |
264 |
$12K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
258 |
227 |
$12K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
200 |
177 |
$8K |
| 80053 |
Comprehensive metabolic panel |
801 |
706 |
$8K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
137 |
122 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
589 |
518 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
137 |
130 |
$2K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17 |
14 |
$861.74 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
31 |
28 |
$809.37 |
| 84443 |
Thyroid stimulating hormone (TSH) |
55 |
53 |
$686.97 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
22 |
12 |
$606.95 |
| 81001 |
|
148 |
135 |
$496.79 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
16 |
16 |
$487.41 |
| G0381 |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
12 |
12 |
$417.80 |
| 87807 |
|
17 |
15 |
$412.42 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
13 |
12 |
$235.28 |
| 87081 |
|
17 |
16 |
$175.22 |
| 85027 |
|
16 |
15 |
$167.64 |
| 83605 |
|
16 |
13 |
$162.54 |
| 71046 |
Radiologic examination, chest; 2 views |
16 |
12 |
$160.41 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
17 |
16 |
$143.04 |
| 87077 |
|
12 |
12 |
$113.11 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15 |
15 |
$91.32 |
| 86140 |
|
13 |
12 |
$67.74 |
| 36415 |
Collection of venous blood by venipuncture |
1,651 |
1,375 |
$39.95 |
| 85610 |
|
42 |
28 |
$39.91 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
107 |
99 |
$0.00 |