| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
231 |
117 |
$34K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
184 |
99 |
$19K |
| 80053 |
Comprehensive metabolic panel |
93 |
75 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
102 |
78 |
$7.77 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
26 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
29 |
24 |
$0.00 |