| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
864 |
844 |
$123K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
326 |
323 |
$44K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
108 |
106 |
$15K |
| G0378 |
Hospital observation service, per hour |
13 |
13 |
$13K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,880 |
1,797 |
$5K |
| 80053 |
Comprehensive metabolic panel |
952 |
849 |
$4K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
232 |
224 |
$3K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
45 |
45 |
$1K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
156 |
147 |
$597.29 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
16 |
15 |
$499.20 |
| 84484 |
|
39 |
36 |
$183.54 |
| 81001 |
|
63 |
62 |
$62.55 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
13 |
12 |
$43.53 |
| 83735 |
|
34 |
24 |
$40.20 |
| 83690 |
|
12 |
12 |
$28.25 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
1,557 |
1,233 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
1,255 |
1,003 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
495 |
441 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
29 |
26 |
$0.00 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
46 |
30 |
$0.00 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
325 |
311 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
379 |
322 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
191 |
186 |
$0.00 |
| A9270 |
Non-covered item or service |
579 |
282 |
$0.00 |
| J3490 |
Unclassified drugs |
107 |
83 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,132 |
907 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
520 |
376 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
421 |
378 |
$0.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
106 |
88 |
$0.00 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
13 |
13 |
$0.00 |