| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,184 |
1,566 |
$350K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
22,380 |
15,463 |
$324K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
263 |
216 |
$41K |
| J0178 |
Injection, aflibercept, 1 mg |
372 |
272 |
$27K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
41 |
39 |
$11K |
| 80053 |
Comprehensive metabolic panel |
365 |
315 |
$7K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
67 |
62 |
$7K |
| 77080 |
|
227 |
181 |
$6K |
| 92134 |
|
2,915 |
2,288 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,191 |
986 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
600 |
500 |
$3K |
| 95811 |
|
12 |
12 |
$3K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
32 |
27 |
$2K |
| 81003 |
|
29 |
25 |
$894.16 |
| 93288 |
|
138 |
111 |
$667.38 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
31 |
26 |
$468.13 |
| 36416 |
|
70 |
52 |
$168.61 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13 |
13 |
$164.97 |
| 77091 |
|
261 |
196 |
$114.18 |
| J0330 |
Injection, succinylcholine chloride, up to 20 mg |
52 |
24 |
$29.87 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
85 |
75 |
$23.19 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
12 |
12 |
$21.20 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
65 |
60 |
$0.00 |
| C9257 |
Injection, bevacizumab, 0.25 mg |
17 |
12 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
82 |
66 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
55 |
39 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
249 |
99 |
$0.00 |