| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
1,146 |
932 |
$42K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
255 |
228 |
$23K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
138 |
121 |
$21K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,012 |
870 |
$17K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
737 |
627 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
933 |
764 |
$8K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17 |
12 |
$7K |
| 80053 |
Comprehensive metabolic panel |
669 |
565 |
$4K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
218 |
196 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
115 |
101 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
265 |
222 |
$1K |
| 84484 |
|
132 |
97 |
$706.53 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
59 |
49 |
$637.07 |
| J3490 |
Unclassified drugs |
206 |
81 |
$487.59 |
| 84443 |
Thyroid stimulating hormone (TSH) |
38 |
36 |
$46.91 |
| 81001 |
|
48 |
43 |
$29.82 |
| A9270 |
Non-covered item or service |
529 |
261 |
$21.85 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
15 |
14 |
$8.08 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
66 |
57 |
$1.56 |
| G0008 |
Administration of influenza virus vaccine |
43 |
43 |
$0.07 |
| 90662 |
|
37 |
37 |
$0.00 |
| 85610 |
|
12 |
12 |
$0.00 |
| 83605 |
|
14 |
12 |
$0.00 |
| 83735 |
|
16 |
14 |
$0.00 |
| 82553 |
|
14 |
12 |
$0.00 |
| 82550 |
|
16 |
13 |
$0.00 |