| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
479 |
422 |
$118K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,010 |
917 |
$69K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,248 |
1,131 |
$47K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
627 |
555 |
$26K |
| 87634 |
|
708 |
621 |
$24K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
627 |
555 |
$21K |
| 80053 |
Comprehensive metabolic panel |
1,376 |
1,130 |
$13K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,413 |
1,264 |
$12K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
397 |
348 |
$10K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
162 |
58 |
$8K |
| 70450 |
Computed tomography, head or brain; without contrast material |
22 |
21 |
$3K |
| 81001 |
|
428 |
376 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
14 |
14 |
$2K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
380 |
250 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
240 |
208 |
$1K |
| 97162 |
|
14 |
14 |
$717.40 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
13 |
13 |
$682.56 |
| 84702 |
|
40 |
40 |
$584.46 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
365 |
329 |
$219.24 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
27 |
26 |
$60.03 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
80 |
76 |
$38.66 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15 |
14 |
$23.80 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
46 |
37 |
$8.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12 |
12 |
$6.72 |
| A9270 |
Non-covered item or service |
604 |
429 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
100 |
84 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
32 |
26 |
$0.00 |
| J2704 |
Injection, propofol, 10 mg |
16 |
14 |
$0.00 |