| CPT |
Description |
Number of Claims |
Sum Performed |
|
A9270
|
NON-COVERED ITEM OR SERVICE |
19
|
20
|
|
G0463
|
HOSPITAL OUTPT CLINIC VISIT |
4
|
4
|
|
96375
|
TX/PRO/DX INJ NEW DRUG ADDON |
3
|
3
|
|
80048
|
METABOLIC PANEL TOTAL CA |
3
|
3
|
|
99284
|
EMERGENCY DEPT VISIT MOD MDM |
3
|
3
|
|
85025
|
COMPLETE CBC W/AUTO DIFF WBC |
3
|
4
|
|
99282
|
EMERGENCY DEPT VISIT SF MDM |
2
|
2
|
|
80053
|
COMPREHEN METABOLIC PANEL |
2
|
2
|
|
96376
|
TX/PRO/DX INJ SAME DRUG ADON |
2
|
3
|
|
83735
|
ASSAY OF MAGNESIUM |
2
|
2
|
|
85610
|
PROTHROMBIN TIME |
2
|
2
|
|
87040
|
BLOOD CULTURE FOR BACTERIA |
2
|
2
|
|
96374
|
THER/PROPH/DIAG INJ IV PUSH |
2
|
2
|
|
G0378
|
HOSPITAL OBSERVATION PER HR |
2
|
31
|
|
J0295
|
AMPICILLIN SULBACTAM 1.5 GM |
2
|
6
|
|
J1100
|
DEXAMETHASONE SODIUM PHOS |
2
|
36
|
|
Q9967
|
LOCM 300-399MG/ML IODINE,1ML |
2
|
76
|
|
99291
|
CRITICAL CARE FIRST HOUR |
2
|
2
|
|
99283
|
EMERGENCY DEPT VISIT LOW MDM |
2
|
2
|
|
86850
|
RBC ANTIBODY SCREEN |
1
|
1
|
