| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
181 |
177 |
$14K |
| 99499 |
|
120 |
88 |
$12K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
13 |
13 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
500 |
433 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
479 |
427 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
122 |
113 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
24 |
24 |
$1K |
| 80076 |
|
63 |
59 |
$441.28 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12 |
12 |
$425.13 |
| 83690 |
|
32 |
28 |
$258.94 |
| 85027 |
|
44 |
41 |
$161.83 |
| 81001 |
|
70 |
68 |
$161.79 |
| 71045 |
Radiologic examination, chest; single view |
30 |
29 |
$107.82 |
| 84484 |
|
13 |
12 |
$50.38 |
| 80053 |
Comprehensive metabolic panel |
31 |
29 |
$24.79 |
| 0250 |
|
160 |
43 |
$0.00 |
| J3490 |
Unclassified drugs |
204 |
99 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
249 |
197 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
17 |
15 |
$0.00 |