| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,403 |
1,259 |
$385K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,290 |
1,177 |
$192K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
353 |
282 |
$86K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
43 |
41 |
$27K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
193 |
189 |
$13K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
27 |
26 |
$12K |
| G0378 |
Hospital observation service, per hour |
65 |
43 |
$9K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
822 |
724 |
$2K |
| 96376 |
|
138 |
72 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
219 |
199 |
$935.92 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
370 |
305 |
$536.11 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
583 |
411 |
$449.50 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
272 |
224 |
$423.37 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
34 |
32 |
$165.95 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
702 |
534 |
$143.57 |
| 83880 |
|
123 |
94 |
$139.94 |
| 71046 |
Radiologic examination, chest; 2 views |
265 |
245 |
$132.82 |
| 80053 |
Comprehensive metabolic panel |
1,419 |
1,200 |
$68.11 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
698 |
573 |
$64.47 |
| 71045 |
Radiologic examination, chest; single view |
562 |
479 |
$44.90 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
409 |
373 |
$36.18 |
| 81025 |
|
438 |
389 |
$32.54 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,874 |
1,456 |
$30.98 |
| 84484 |
|
644 |
469 |
$21.53 |
| 83690 |
|
522 |
467 |
$17.78 |
| 82553 |
|
184 |
158 |
$15.32 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
590 |
524 |
$11.12 |
| 81003 |
|
421 |
373 |
$8.49 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
240 |
202 |
$7.10 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
214 |
197 |
$6.99 |
| A9270 |
Non-covered item or service |
3,429 |
1,381 |
$4.56 |
| 81001 |
|
742 |
650 |
$4.37 |
| 83735 |
|
455 |
315 |
$4.05 |
| 70450 |
Computed tomography, head or brain; without contrast material |
239 |
212 |
$2.43 |
| 82962 |
|
265 |
104 |
$0.00 |
| 83605 |
|
50 |
42 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
446 |
329 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
301 |
265 |
$0.00 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
20 |
13 |
$0.00 |
| 82550 |
|
229 |
195 |
$0.00 |
| 87081 |
|
143 |
132 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
92 |
74 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
44 |
37 |
$0.00 |
| 85730 |
|
139 |
124 |
$0.00 |
| 85379 |
|
12 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
44 |
25 |
$0.00 |
| 87040 |
|
19 |
12 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
33 |
27 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
22 |
19 |
$0.00 |
| 85610 |
|
345 |
287 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
601 |
491 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
300 |
203 |
$0.00 |
| 80306 |
|
58 |
48 |
$0.00 |
| 84702 |
|
17 |
14 |
$0.00 |
| 84100 |
|
16 |
14 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
90 |
73 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
156 |
124 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
50 |
45 |
$0.00 |
| 87186 |
|
14 |
14 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
13 |
$0.00 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
15 |
12 |
$0.00 |