| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X4003 |
|
1,292 |
1,144 |
$342K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,433 |
2,512 |
$202K |
| 62323 |
|
1,110 |
485 |
$145K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,869 |
1,529 |
$131K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,968 |
4,334 |
$123K |
| Y7506 |
|
773 |
600 |
$116K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
2,270 |
1,645 |
$105K |
| J3490 |
Unclassified drugs |
716 |
599 |
$53K |
| A0425 |
Ground mileage, per statute mile |
1,376 |
1,071 |
$32K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,129 |
2,480 |
$28K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
199 |
171 |
$20K |
| 80053 |
Comprehensive metabolic panel |
1,120 |
1,002 |
$12K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
231 |
191 |
$11K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
182 |
148 |
$11K |
| X4011 |
State-specific procedure code |
58 |
52 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,217 |
1,083 |
$9K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
223 |
201 |
$7K |
| 0002A |
|
134 |
89 |
$4K |
| 0001A |
|
119 |
76 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
81 |
71 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
448 |
386 |
$3K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
20 |
13 |
$2K |
| 80305 |
|
234 |
200 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
113 |
89 |
$1K |
| 99152 |
|
85 |
64 |
$933.89 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
15 |
14 |
$743.21 |
| 87428 |
|
30 |
28 |
$566.84 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
21 |
18 |
$410.71 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$393.25 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
18 |
12 |
$381.44 |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
25 |
23 |
$377.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19 |
15 |
$358.21 |
| 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 |
19 |
17 |
$300.00 |
| 71045 |
Radiologic examination, chest; single view |
33 |
15 |
$251.25 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
138 |
126 |
$242.88 |
| 83605 |
|
43 |
37 |
$196.27 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$153.46 |
| 81001 |
|
25 |
24 |
$40.58 |