| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80053 |
Comprehensive metabolic panel |
194 |
166 |
$9K |
| 36415 |
Collection of venous blood by venipuncture |
155 |
126 |
$8K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
59 |
59 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
129 |
109 |
$5K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
185 |
173 |
$4K |
| 87081 |
|
50 |
47 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
90 |
74 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
139 |
106 |
$2K |
| 81001 |
|
111 |
105 |
$1K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
14 |
14 |
$875.94 |
| 81003 |
|
49 |
41 |
$845.32 |
| 70450 |
Computed tomography, head or brain; without contrast material |
39 |
36 |
$540.08 |
| 71045 |
Radiologic examination, chest; single view |
24 |
21 |
$463.27 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
120 |
90 |
$377.18 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
48 |
35 |
$367.42 |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
174 |
153 |
$265.11 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
39 |
38 |
$236.34 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
37 |
34 |
$187.99 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
37 |
37 |
$180.64 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
113 |
102 |
$167.29 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
265 |
232 |
$116.84 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
118 |
96 |
$97.26 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
168 |
144 |
$95.85 |
| 81025 |
|
59 |
55 |
$75.87 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
71 |
62 |
$37.70 |
| 83605 |
|
35 |
28 |
$0.00 |
| 85027 |
|
15 |
12 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
26 |
25 |
$0.00 |
| 83735 |
|
49 |
36 |
$0.00 |
| 84484 |
|
61 |
53 |
$0.00 |
| 83690 |
|
74 |
63 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
50 |
32 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
20 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
45 |
41 |
$0.00 |
| 96376 |
|
14 |
13 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
17 |
12 |
$0.00 |
| 85730 |
|
18 |
17 |
$0.00 |
| 83880 |
|
19 |
18 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
121 |
94 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
85 |
67 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
14 |
13 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
59 |
58 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
47 |
43 |
$0.00 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
15 |
13 |
$0.00 |
| 85610 |
|
40 |
38 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
16 |
15 |
$0.00 |