| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,595 |
2,547 |
$153K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,157 |
1,141 |
$120K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
752 |
618 |
$45K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
180 |
172 |
$14K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
324 |
321 |
$13K |
| 71046 |
Radiologic examination, chest; 2 views |
956 |
925 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
128 |
123 |
$9K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
1,107 |
1,005 |
$8K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
265 |
258 |
$8K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
65 |
65 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
580 |
530 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
261 |
254 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
91 |
89 |
$3K |
| 73610 |
|
150 |
140 |
$1K |
| 73630 |
|
147 |
134 |
$1K |
| 73562 |
|
101 |
93 |
$819.81 |
| 73030 |
|
94 |
72 |
$654.38 |
| 73130 |
|
60 |
57 |
$490.65 |
| 93000 |
|
43 |
38 |
$488.53 |
| 73110 |
|
59 |
54 |
$457.39 |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
30 |
25 |
$402.64 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
12 |
$362.25 |
| A0425 |
Ground mileage, per statute mile |
56 |
48 |
$155.24 |
| 3078F |
|
409 |
357 |
$0.00 |
| 1036F |
|
440 |
351 |
$0.00 |
| 3074F |
|
311 |
279 |
$0.00 |
| 3008F |
|
533 |
473 |
$0.00 |