| Code | Description | Claims | Beneficiaries | Total Paid |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
1,187 |
1,156 |
$25K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
1,197 |
1,173 |
$18K |
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
28 |
28 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24 |
24 |
$2K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
527 |
490 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
35 |
32 |
$18.41 |
| 99406 |
|
41 |
35 |
$5.31 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
645 |
628 |
$0.00 |
| 99053 |
|
33 |
33 |
$0.00 |