| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,314 |
947 |
$689K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
758 |
728 |
$137K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
1,026 |
975 |
$102K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
190 |
168 |
$91K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
802 |
667 |
$77K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
85 |
65 |
$43K |
| J7699 |
Noc drugs, inhalation solution administered through dme |
86 |
64 |
$7K |
| J3490 |
Unclassified drugs |
680 |
388 |
$6K |
| 80053 |
Comprehensive metabolic panel |
1,050 |
939 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,349 |
1,180 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,503 |
1,265 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
71 |
45 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
13 |
12 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
36 |
29 |
$1K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
934 |
697 |
$915.24 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
117 |
111 |
$877.00 |
| 87147 |
|
83 |
80 |
$449.58 |
| 81001 |
|
199 |
179 |
$244.29 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
375 |
280 |
$151.04 |
| 87186 |
|
15 |
14 |
$150.23 |
| 87077 |
|
15 |
14 |
$140.29 |
| 84443 |
Thyroid stimulating hormone (TSH) |
87 |
87 |
$117.42 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
98 |
70 |
$114.48 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
455 |
359 |
$83.51 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
688 |
533 |
$80.81 |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
70 |
54 |
$52.52 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
14 |
14 |
$40.55 |
| 80061 |
Lipid panel |
93 |
93 |
$29.20 |
| 85610 |
|
12 |
12 |
$24.43 |
| 84439 |
|
12 |
12 |
$12.35 |
| J2704 |
Injection, propofol, 10 mg |
109 |
83 |
$10.80 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
50 |
50 |
$7.75 |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
116 |
82 |
$4.68 |
| A4217 |
Sterile water/saline, 500 ml |
74 |
59 |
$2.88 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
26 |
13 |
$0.00 |