| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
332 |
313 |
$369K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
789 |
762 |
$297K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
42 |
38 |
$7K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
81 |
79 |
$3K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
17 |
17 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,375 |
1,211 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
39 |
$3K |
| 80053 |
Comprehensive metabolic panel |
1,008 |
933 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
92 |
81 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
21 |
19 |
$1K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
163 |
157 |
$914.03 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
95 |
89 |
$716.38 |
| 87430 |
|
22 |
22 |
$616.71 |
| 87070 |
|
21 |
21 |
$496.77 |
| 81001 |
|
144 |
134 |
$126.84 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
48 |
39 |
$101.29 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14 |
13 |
$70.15 |
| 36415 |
Collection of venous blood by venipuncture |
1,340 |
1,149 |
$65.58 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14 |
13 |
$47.44 |
| 80061 |
Lipid panel |
189 |
189 |
$41.51 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
137 |
116 |
$6.75 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
114 |
114 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
141 |
139 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
26 |
24 |
$0.00 |
| A9270 |
Non-covered item or service |
27 |
26 |
$0.00 |
| 84484 |
|
16 |
12 |
$0.00 |
| 82550 |
|
15 |
12 |
$0.00 |
| 85610 |
|
16 |
12 |
$0.00 |
| 82248 |
|
12 |
12 |
$0.00 |