| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
253 |
222 |
$31K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
320 |
271 |
$28K |
| 80053 |
Comprehensive metabolic panel |
488 |
421 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
405 |
353 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
31 |
24 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
103 |
91 |
$1K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
16 |
13 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
46 |
40 |
$1K |
| 83735 |
|
169 |
138 |
$545.08 |
| 81000 |
|
260 |
218 |
$461.12 |
| 99070 |
|
70 |
63 |
$349.23 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
20 |
13 |
$306.77 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
18 |
13 |
$217.30 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
21 |
14 |
$203.69 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
18 |
13 |
$200.40 |
| 36415 |
Collection of venous blood by venipuncture |
148 |
121 |
$199.92 |
| 87899 |
|
13 |
13 |
$175.32 |
| 86140 |
|
13 |
12 |
$47.67 |
| A9270 |
Non-covered item or service |
18 |
12 |
$0.46 |