| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J3490 |
Unclassified drugs |
4,056 |
781 |
$337K |
| 36415 |
Collection of venous blood by venipuncture |
324 |
246 |
$91K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
573 |
560 |
$78K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
364 |
350 |
$62K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
335 |
215 |
$42K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
481 |
298 |
$38K |
| 80053 |
Comprehensive metabolic panel |
287 |
225 |
$37K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
364 |
329 |
$33K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
123 |
121 |
$15K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
768 |
598 |
$10K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
147 |
140 |
$7K |
| 87631 |
|
41 |
39 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
254 |
245 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
314 |
308 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
82 |
12 |
$2K |
| M0239 |
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring |
63 |
12 |
$2K |
| 87486 |
|
13 |
13 |
$776.10 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
118 |
115 |
$607.55 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$570.37 |
| 87807 |
|
97 |
90 |
$17.56 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
14 |
14 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
13 |
13 |
$0.00 |
| 87581 |
|
13 |
13 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
13 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13 |
13 |
$0.00 |