| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
741 |
623 |
$13K |
| 64415 |
|
27 |
27 |
$5K |
| 99220 |
|
50 |
40 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
210 |
191 |
$1K |
| 76942 |
|
27 |
27 |
$1K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
388 |
212 |
$1K |
| 86769 |
|
119 |
107 |
$676.69 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
158 |
145 |
$637.37 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
253 |
203 |
$624.03 |
| 76937 |
|
29 |
25 |
$418.31 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
252 |
218 |
$374.86 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
54 |
53 |
$264.19 |
| 99217 |
|
12 |
12 |
$228.90 |
| 80053 |
Comprehensive metabolic panel |
58 |
53 |
$182.62 |
| 85730 |
|
211 |
190 |
$146.67 |
| J2795 |
Injection, ropivacaine hydrochloride, 1 mg |
24 |
24 |
$139.56 |
| J1644 |
Injection, heparin sodium, per 1000 units |
245 |
198 |
$129.27 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
29 |
27 |
$114.97 |
| 85610 |
|
211 |
190 |
$103.63 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
166 |
145 |
$96.44 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
73 |
64 |
$53.01 |
| 36415 |
Collection of venous blood by venipuncture |
474 |
294 |
$22.42 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
161 |
145 |
$11.73 |
| G0378 |
Hospital observation service, per hour |
13 |
13 |
$0.00 |
| J3490 |
Unclassified drugs |
90 |
57 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
48 |
26 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
17 |
13 |
$0.00 |