| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
65 |
65 |
$10K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
12 |
12 |
$2K |
| A9270 |
Non-covered item or service |
223 |
65 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
107 |
83 |
$0.00 |
| 83690 |
|
24 |
24 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
94 |
77 |
$0.00 |
| 84484 |
|
23 |
14 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
14 |
12 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
73 |
68 |
$0.00 |
| 81001 |
|
39 |
38 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
32 |
29 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
13 |
12 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13 |
12 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18 |
16 |
$0.00 |