| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
85 |
81 |
$15K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
50 |
47 |
$9K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
12 |
12 |
$6K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
31 |
30 |
$5K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
22 |
19 |
$5K |
| 87631 |
|
32 |
32 |
$4K |
| 80053 |
Comprehensive metabolic panel |
40 |
37 |
$404.31 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
52 |
47 |
$368.68 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$170.94 |
| 87081 |
|
12 |
12 |
$72.48 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
23 |
19 |
$27.92 |
| 71046 |
Radiologic examination, chest; 2 views |
18 |
18 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
15 |
15 |
$0.00 |