| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
Comprehensive metabolic panel |
114 |
99 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
115 |
94 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
85 |
76 |
$4K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
41 |
39 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
59 |
43 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
87 |
63 |
$2K |
| 87081 |
|
29 |
28 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
172 |
150 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
122 |
106 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13 |
12 |
$672.34 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
107 |
93 |
$608.21 |
| 81001 |
|
56 |
51 |
$435.32 |
| 70450 |
Computed tomography, head or brain; without contrast material |
16 |
12 |
$378.89 |
| 81025 |
|
23 |
19 |
$200.07 |
| 85610 |
|
34 |
28 |
$166.98 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
50 |
37 |
$161.11 |
| 81003 |
|
31 |
24 |
$100.56 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
76 |
59 |
$97.26 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
15 |
15 |
$89.12 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
179 |
144 |
$6.16 |
| 84484 |
|
41 |
26 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
24 |
16 |
$0.00 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
58 |
44 |
$0.00 |
| 83690 |
|
35 |
32 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
37 |
32 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
13 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
38 |
37 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
46 |
34 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
59 |
50 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
29 |
24 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
59 |
49 |
$0.00 |