| Code | Description | Claims | Beneficiaries | Total Paid |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,256 |
1,037 |
$25K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
684 |
548 |
$18K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
211 |
177 |
$9K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
206 |
151 |
$8K |
| 71046 |
Radiologic examination, chest; 2 views |
167 |
153 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
15 |
12 |
$39.27 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
14 |
$33.22 |
| T1015 |
Clinic visit/encounter, all-inclusive |
68 |
34 |
$0.00 |