| Code | Description | Claims | Beneficiaries | Total Paid |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
42 |
38 |
$7K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
89 |
89 |
$6K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
31 |
27 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
33 |
29 |
$516.64 |
| 36415 |
Collection of venous blood by venipuncture |
52 |
37 |
$30.12 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17 |
13 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
18 |
14 |
$0.00 |