| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
81,745 |
53,294 |
$3.90M |
| 0300 |
|
70,003 |
20,092 |
$874K |
| 0636 |
|
18,961 |
7,700 |
$202K |
| 0320 |
|
6,206 |
5,414 |
$129K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,282 |
982 |
$128K |
| 0761 |
|
3,229 |
2,760 |
$126K |
| 0270 |
|
14,225 |
13,392 |
$109K |
| 0350 |
|
625 |
498 |
$83K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
993 |
911 |
$54K |
| Z9725 |
|
949 |
943 |
$33K |
| 0250 |
|
3,540 |
2,669 |
$23K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,800 |
3,571 |
$21K |
| 80053 |
Comprehensive metabolic panel |
2,345 |
2,252 |
$20K |
| 0360 |
|
249 |
191 |
$20K |
| A9270 |
Non-covered item or service |
768 |
644 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
991 |
914 |
$14K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
566 |
527 |
$9K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
443 |
409 |
$9K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
497 |
454 |
$9K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
168 |
159 |
$8K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
113 |
109 |
$7K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
613 |
575 |
$7K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
393 |
348 |
$6K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
37 |
35 |
$5K |
| 0730 |
|
178 |
177 |
$5K |
| 81001 |
|
2,104 |
2,019 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
159 |
140 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
125 |
122 |
$4K |
| Z7502 |
|
104 |
102 |
$4K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
372 |
347 |
$3K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
469 |
437 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
457 |
426 |
$2K |
| 86140 |
|
491 |
480 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
408 |
386 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
264 |
258 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
12 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
13 |
13 |
$1K |
| 0402 |
|
21 |
16 |
$1K |
| 83690 |
|
380 |
355 |
$1K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
14 |
12 |
$924.98 |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
58 |
52 |
$909.16 |
| 0500 |
|
39 |
39 |
$824.87 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
58 |
57 |
$749.33 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
381 |
342 |
$709.99 |
| 85610 |
|
335 |
324 |
$703.72 |
| 84484 |
|
320 |
282 |
$693.18 |
| 0410 |
|
38 |
33 |
$653.61 |
| 87081 |
|
122 |
122 |
$641.72 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
177 |
164 |
$525.64 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
211 |
192 |
$404.67 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
96 |
86 |
$391.55 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
14 |
14 |
$277.19 |
| 0255 |
|
19 |
18 |
$202.95 |
| 87420 |
|
55 |
49 |
$199.32 |
| 0274 |
|
166 |
157 |
$186.69 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
82 |
76 |
$186.14 |
| 86850 |
|
32 |
30 |
$152.66 |
| 86803 |
|
13 |
13 |
$133.45 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
33 |
27 |
$128.62 |
| J3490 |
Unclassified drugs |
13 |
12 |
$107.73 |
| 80076 |
|
14 |
14 |
$90.02 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$87.30 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
14 |
12 |
$85.46 |
| 87400 |
|
23 |
19 |
$82.20 |
| 0258 |
|
12 |
12 |
$79.92 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
34 |
28 |
$78.84 |
| 81025 |
|
28 |
24 |
$62.38 |
| 85730 |
|
50 |
50 |
$21.44 |
| 0750 |
|
13 |
13 |
$0.00 |
| 82962 |
|
23 |
12 |
$0.00 |