| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
114,260 |
103,530 |
$6.62M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
92,739 |
85,933 |
$5.11M |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
53,460 |
47,854 |
$3.49M |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
8,759 |
8,433 |
$1.04M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
6,069 |
5,915 |
$331K |
| 10061 |
|
1,091 |
1,061 |
$94K |
| 12001 |
|
2,949 |
2,914 |
$74K |
| 12011 |
|
1,514 |
1,505 |
$49K |
| 12002 |
|
1,360 |
1,348 |
$45K |
| 93042 |
|
12,820 |
11,943 |
$41K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
574 |
562 |
$27K |
| 31500 |
|
163 |
161 |
$12K |
| 99292 |
|
154 |
152 |
$11K |
| 10060 |
|
252 |
247 |
$11K |
| 64400 |
|
178 |
161 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
195 |
189 |
$3K |
| 99152 |
|
195 |
191 |
$1K |
| 93308 |
|
95 |
94 |
$1K |
| 36556 |
|
14 |
14 |
$538.29 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$205.50 |
| 99053 |
|
1,251 |
1,212 |
$20.02 |
| G8708 |
Patient not prescribed antibiotic |
7,055 |
6,925 |
$0.01 |
| G9530 |
Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider |
2,533 |
2,483 |
$0.00 |
| G9529 |
Patient with minor blunt head trauma had an appropriate indication(s) for a head ct |
2,400 |
2,353 |
$0.00 |
| G8711 |
Prescribed antibiotic on or within 3 days after the episode date |
1,119 |
1,105 |
$0.00 |
| G9350 |
Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis |
54 |
53 |
$0.00 |
| 4130F |
|
31 |
30 |
$0.00 |
| G9532 |
Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma |
224 |
217 |
$0.00 |
| G9594 |
Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider |
64 |
64 |
$0.00 |
| 4132F |
|
31 |
30 |
$0.00 |
| G9597 |
Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules |
39 |
39 |
$0.00 |
| G9712 |
Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis |
14 |
14 |
$0.00 |
| G8806 |
Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented |
2,042 |
1,933 |
$0.00 |
| 3210F |
|
1,159 |
1,145 |
$0.00 |
| G8712 |
Antibiotic not prescribed or dispensed |
1,658 |
1,637 |
$0.00 |
| 4124F |
|
659 |
641 |
$0.00 |
| G8709 |
Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne) |
145 |
145 |
$0.00 |
| G9596 |
Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma |
135 |
134 |
$0.00 |
| G9533 |
Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct |
54 |
52 |
$0.00 |
| 4120F |
|
18 |
17 |
$0.00 |