| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0450 |
Emergency room services |
3,600 |
3,309 |
$146K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
190 |
185 |
$14K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,269 |
1,178 |
$5K |
| 80051 |
|
1,163 |
1,047 |
$4K |
| 82565 |
|
1,306 |
1,191 |
$3K |
| 82947 |
|
1,270 |
1,175 |
$2K |
| 84520 |
|
1,302 |
1,191 |
$2K |
| 90686 |
|
110 |
110 |
$2K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
65 |
63 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
33 |
33 |
$2K |
| 83690 |
|
311 |
297 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
73 |
73 |
$1K |
| 84460 |
|
374 |
352 |
$1K |
| 84450 |
|
349 |
331 |
$903.80 |
| 82247 |
|
362 |
338 |
$876.83 |
| 84075 |
|
334 |
314 |
$859.99 |
| 81003 |
|
658 |
630 |
$782.23 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
99 |
88 |
$605.20 |
| 84484 |
|
79 |
66 |
$447.35 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14 |
12 |
$432.67 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
67 |
62 |
$423.92 |
| 71045 |
Radiologic examination, chest; single view |
41 |
41 |
$396.30 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
70 |
67 |
$267.35 |
| 85610 |
|
91 |
83 |
$194.97 |
| 84702 |
|
28 |
26 |
$164.16 |
| 87088 |
|
37 |
37 |
$139.76 |
| 82248 |
|
46 |
46 |
$116.45 |
| 82310 |
|
54 |
51 |
$110.70 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
13 |
$81.42 |
| J3490 |
Unclassified drugs |
84 |
56 |
$3.61 |
| 99199 |
Unlisted special service, procedure or report |
611 |
590 |
$0.00 |
| 0637 |
|
357 |
212 |
$0.00 |
| 0258 |
|
163 |
150 |
$0.00 |