| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,062 |
888 |
$79K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
787 |
650 |
$65K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
133 |
109 |
$36K |
| G0378 |
Hospital observation service, per hour |
220 |
180 |
$12K |
| 70450 |
Computed tomography, head or brain; without contrast material |
19 |
15 |
$997.36 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
23 |
17 |
$700.17 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
150 |
135 |
$660.82 |
| 80053 |
Comprehensive metabolic panel |
851 |
563 |
$450.04 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
23 |
12 |
$371.08 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
21 |
17 |
$183.90 |
| 71045 |
Radiologic examination, chest; single view |
164 |
129 |
$182.87 |
| 88342 |
|
93 |
84 |
$90.42 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
134 |
114 |
$17.25 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,648 |
1,019 |
$3.22 |
| 82397 |
|
19 |
16 |
$0.00 |
| 85610 |
|
46 |
37 |
$0.00 |
| 93041 |
|
31 |
25 |
$0.00 |
| 81001 |
|
597 |
491 |
$0.00 |
| 85652 |
|
19 |
16 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
35 |
26 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
300 |
241 |
$0.00 |
| 82550 |
|
15 |
12 |
$0.00 |
| J2175 |
Injection, meperidine hydrochloride, per 100 mg |
219 |
170 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
221 |
172 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
69 |
50 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
17 |
13 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
15 |
13 |
$0.00 |
| 84484 |
|
117 |
85 |
$0.00 |
| 85730 |
|
46 |
37 |
$0.00 |