| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97116 |
|
156 |
96 |
$6K |
| 64447 |
|
26 |
12 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
582 |
476 |
$1K |
| 97161 |
|
100 |
68 |
$1K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
15 |
15 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
94 |
78 |
$718.23 |
| 94762 |
|
66 |
29 |
$664.37 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
34 |
29 |
$266.95 |
| 80053 |
Comprehensive metabolic panel |
13 |
13 |
$138.37 |
| 85730 |
|
12 |
12 |
$78.89 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
832 |
483 |
$53.20 |
| 85610 |
|
12 |
12 |
$39.41 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
748 |
539 |
$27.34 |
| J1170 |
Injection, hydromorphone, up to 4 mg |
347 |
190 |
$15.25 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
536 |
379 |
$12.57 |
| J2704 |
Injection, propofol, 10 mg |
808 |
529 |
$11.34 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
601 |
438 |
$5.56 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
636 |
460 |
$1.56 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
586 |
423 |
$1.08 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
85 |
84 |
$0.00 |
| C1713 |
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) |
140 |
94 |
$0.00 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
231 |
168 |
$0.00 |
| J3371 |
Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mg |
16 |
12 |
$0.00 |
| C1776 |
Joint device (implantable) |
232 |
173 |
$0.00 |
| J0171 |
Injection, adrenalin, epinephrine, 0.1 mg |
323 |
207 |
$0.00 |
| J1171 |
Injection, hydromorphone, 0.1 mg |
22 |
17 |
$0.00 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
562 |
336 |
$0.00 |
| J2370 |
Injection, phenylephrine hcl, up to 1 ml |
40 |
25 |
$0.00 |