| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
2,459 |
1,379 |
$141K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
802 |
652 |
$97K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
721 |
646 |
$70K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
703 |
400 |
$48K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
611 |
399 |
$42K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
332 |
307 |
$21K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
333 |
308 |
$4K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
188 |
171 |
$3K |
| 80053 |
Comprehensive metabolic panel |
735 |
580 |
$994.76 |
| 71045 |
Radiologic examination, chest; single view |
54 |
25 |
$738.95 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
16 |
15 |
$717.39 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
22 |
12 |
$578.82 |
| J3490 |
Unclassified drugs |
1,572 |
780 |
$485.39 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
16 |
13 |
$437.99 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
60 |
52 |
$157.50 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
929 |
721 |
$119.63 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
59 |
57 |
$80.60 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$60.36 |
| 84484 |
|
14 |
12 |
$38.11 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
70 |
62 |
$22.92 |
| 85027 |
|
40 |
24 |
$0.00 |
| 81001 |
|
40 |
39 |
$0.00 |