| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
133 |
117 |
$5K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
107 |
101 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
23 |
23 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
34 |
31 |
$2K |
| 80053 |
Comprehensive metabolic panel |
109 |
90 |
$1K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
26 |
21 |
$997.15 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
23 |
20 |
$888.54 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
125 |
105 |
$532.27 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
24 |
19 |
$443.10 |
| 87400 |
|
62 |
29 |
$440.42 |
| 71046 |
Radiologic examination, chest; 2 views |
28 |
26 |
$221.35 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
17 |
12 |
$201.85 |
| 81001 |
|
77 |
68 |
$192.50 |
| 87420 |
|
15 |
15 |
$176.12 |
| 87088 |
|
17 |
16 |
$171.73 |
| 83690 |
|
16 |
13 |
$138.74 |
| 86140 |
|
17 |
13 |
$111.02 |
| 81025 |
|
12 |
12 |
$93.50 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
17 |
13 |
$57.36 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
21 |
18 |
$44.12 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
52 |
42 |
$15.22 |
| 36415 |
Collection of venous blood by venipuncture |
146 |
116 |
$0.00 |