| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 36415 |
Collection of venous blood by venipuncture |
404 |
314 |
$20K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
167 |
151 |
$5K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
33 |
31 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
93 |
80 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
92 |
57 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
41 |
40 |
$2K |
| 87081 |
|
36 |
36 |
$2K |
| 81001 |
|
119 |
108 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
195 |
169 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
337 |
253 |
$1K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
105 |
83 |
$1K |
| 86850 |
|
18 |
17 |
$983.79 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
57 |
48 |
$934.97 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
110 |
81 |
$699.02 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
137 |
97 |
$694.31 |
| 80053 |
Comprehensive metabolic panel |
188 |
162 |
$554.12 |
| 81003 |
|
41 |
39 |
$455.19 |
| 71046 |
Radiologic examination, chest; 2 views |
118 |
91 |
$451.30 |
| 70450 |
Computed tomography, head or brain; without contrast material |
61 |
59 |
$349.12 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
87 |
84 |
$301.18 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
130 |
106 |
$247.18 |
| 87077 |
|
15 |
15 |
$136.53 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
125 |
96 |
$100.79 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
37 |
31 |
$100.79 |
| 84443 |
Thyroid stimulating hormone (TSH) |
52 |
51 |
$39.90 |
| 80061 |
Lipid panel |
18 |
18 |
$38.36 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
188 |
168 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
14 |
13 |
$0.00 |
| 85730 |
|
14 |
14 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
31 |
26 |
$0.00 |
| P9612 |
Catheterization for collection of specimen, single patient, all places of service |
15 |
15 |
$0.00 |
| 85027 |
|
20 |
17 |
$0.00 |
| 83735 |
|
62 |
40 |
$0.00 |
| G0378 |
Hospital observation service, per hour |
19 |
17 |
$0.00 |
| 87040 |
|
18 |
16 |
$0.00 |
| 83880 |
|
29 |
26 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
48 |
41 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
18 |
12 |
$0.00 |
| 86592 |
|
16 |
16 |
$0.00 |
| 83690 |
|
53 |
50 |
$0.00 |
| 82550 |
|
26 |
17 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
42 |
37 |
$0.00 |
| 87340 |
|
15 |
15 |
$0.00 |
| 85651 |
|
19 |
13 |
$0.00 |
| 84484 |
|
83 |
63 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
13 |
12 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
79 |
66 |
$0.00 |
| 96376 |
|
36 |
30 |
$0.00 |
| J3490 |
Unclassified drugs |
16 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
17 |
17 |
$0.00 |
| 86901 |
|
22 |
21 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
31 |
25 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
33 |
30 |
$0.00 |
| 86762 |
|
14 |
14 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
17 |
17 |
$0.00 |
| 83605 |
|
23 |
23 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
69 |
65 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
89 |
71 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
135 |
96 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
17 |
$0.00 |
| 86900 |
|
22 |
21 |
$0.00 |
| 87186 |
|
12 |
12 |
$0.00 |
| 81025 |
|
17 |
17 |
$0.00 |
| J2550 |
Injection, promethazine hcl, up to 50 mg |
35 |
31 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
51 |
43 |
$0.00 |
| 85610 |
|
46 |
42 |
$0.00 |