| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
81 |
55 |
$16K |
| 99213 |
|
211 |
60 |
$6K |
| 80053 |
|
147 |
69 |
$4K |
| 99284 |
|
35 |
19 |
$4K |
| 97530 |
|
45 |
12 |
$4K |
| A0425 |
Ground mileage, per statute mile |
522 |
338 |
$3K |
| 36415 |
|
535 |
386 |
$3K |
| 87804 |
|
37 |
28 |
$2K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
13 |
12 |
$2K |
| 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 |
16 |
14 |
$2K |
| 85025 |
|
236 |
126 |
$1K |
| 87081 |
|
18 |
15 |
$1K |
| 86769 |
|
16 |
14 |
$1K |
| 83036 |
|
15 |
12 |
$567.12 |
| 97140 |
|
31 |
12 |
$382.40 |
| 81230 |
|
26 |
13 |
$240.48 |
| 0031U |
|
27 |
14 |
$240.48 |
| 81355 |
|
21 |
12 |
$175.44 |
| 81479 |
|
81 |
14 |
$131.58 |
| 0032U |
|
27 |
14 |
$120.24 |
| 81401 |
|
27 |
14 |
$87.72 |
| 81291 |
|
27 |
14 |
$43.86 |
| A9150 |
Non-prescription drugs |
34 |
25 |
$0.00 |
| 96374 |
|
58 |
12 |
$0.00 |
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
50 |
48 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
18 |
17 |
$0.00 |