| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
4,151 |
3,482 |
$227K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
785 |
587 |
$85K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,312 |
1,033 |
$62K |
| 80047 |
|
1,540 |
1,190 |
$30K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
277 |
226 |
$17K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
182 |
142 |
$13K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
118 |
102 |
$13K |
| 85027 |
|
1,949 |
1,456 |
$8K |
| 70450 |
Computed tomography, head or brain; without contrast material |
47 |
40 |
$4K |
| 82150 |
|
835 |
674 |
$3K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
617 |
443 |
$3K |
| 82977 |
|
833 |
672 |
$3K |
| 84460 |
|
791 |
640 |
$2K |
| 84450 |
|
791 |
640 |
$2K |
| 84075 |
|
791 |
640 |
$2K |
| 82040 |
|
772 |
627 |
$2K |
| 82247 |
|
792 |
641 |
$2K |
| 81003 |
|
970 |
787 |
$2K |
| 84155 |
|
790 |
639 |
$2K |
| 84484 |
|
184 |
121 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
224 |
180 |
$973.55 |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
16 |
15 |
$782.50 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14 |
13 |
$528.51 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,242 |
940 |
$479.95 |
| 81025 |
|
57 |
54 |
$412.21 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
661 |
511 |
$241.22 |
| 71046 |
Radiologic examination, chest; 2 views |
299 |
259 |
$240.74 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
16 |
15 |
$50.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
795 |
636 |
$35.75 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
612 |
470 |
$20.43 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
537 |
437 |
$3.95 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
247 |
182 |
$1.94 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
22 |
14 |
$0.00 |
| 71045 |
Radiologic examination, chest; single view |
111 |
87 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |
| 96376 |
|
15 |
12 |
$0.00 |