| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,346 |
1,236 |
$324K |
| 80053 |
Comprehensive metabolic panel |
2,226 |
2,011 |
$232K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,912 |
1,776 |
$215K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,687 |
1,578 |
$134K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
170 |
162 |
$113K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
997 |
914 |
$13K |
| 70450 |
Computed tomography, head or brain; without contrast material |
333 |
304 |
$12K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
28 |
24 |
$9K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
17 |
16 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
25 |
25 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
12 |
12 |
$652.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
980 |
874 |
$290.23 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
361 |
340 |
$62.89 |
| 71045 |
Radiologic examination, chest; single view |
749 |
705 |
$57.30 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
812 |
736 |
$25.16 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,293 |
2,075 |
$11.29 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
588 |
285 |
$8.84 |
| 84484 |
|
792 |
655 |
$8.47 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
315 |
307 |
$5.99 |
| 83605 |
|
717 |
542 |
$5.98 |
| 87081 |
|
151 |
148 |
$3.32 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
178 |
167 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,461 |
2,190 |
$0.00 |
| 87428 |
|
358 |
343 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,229 |
1,131 |
$0.00 |
| 80320 |
|
154 |
144 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
830 |
739 |
$0.00 |
| A9270 |
Non-covered item or service |
45 |
24 |
$0.00 |
| 83735 |
|
874 |
817 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
203 |
195 |
$0.00 |
| 82077 |
|
120 |
91 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
413 |
379 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
291 |
271 |
$0.00 |
| 87807 |
|
15 |
14 |
$0.00 |
| 83690 |
|
47 |
41 |
$0.00 |
| 82150 |
|
193 |
189 |
$0.00 |
| 85379 |
|
103 |
99 |
$0.00 |
| 96376 |
|
13 |
12 |
$0.00 |
| 82550 |
|
19 |
15 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12 |
12 |
$0.00 |
| 85027 |
|
12 |
12 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
756 |
652 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
238 |
188 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,813 |
1,476 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
575 |
541 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
328 |
312 |
$0.00 |
| 84702 |
|
96 |
84 |
$0.00 |
| 81025 |
|
200 |
191 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
24 |
24 |
$0.00 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
165 |
157 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
15 |
13 |
$0.00 |
| 81003 |
|
44 |
41 |
$0.00 |