| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
882 |
841 |
$199K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
611 |
596 |
$34K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
449 |
437 |
$18K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
451 |
443 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
411 |
404 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
181 |
172 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
783 |
646 |
$4K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15 |
13 |
$4K |
| 87420 |
|
92 |
92 |
$1K |
| 80053 |
Comprehensive metabolic panel |
178 |
151 |
$1K |
| 87430 |
|
27 |
27 |
$346.75 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
85 |
67 |
$320.59 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
17 |
13 |
$300.11 |
| 87081 |
|
26 |
26 |
$136.84 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
16 |
13 |
$92.26 |
| 81001 |
|
28 |
27 |
$45.01 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13 |
12 |
$6.08 |
| 36415 |
Collection of venous blood by venipuncture |
101 |
90 |
$0.00 |
| A9270 |
Non-covered item or service |
28 |
27 |
$0.00 |