| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
562 |
461 |
$901K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
334 |
250 |
$28K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
124 |
114 |
$15K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
39 |
30 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
852 |
703 |
$4K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
30 |
24 |
$3K |
| 43235 |
|
33 |
27 |
$2K |
| 80053 |
Comprehensive metabolic panel |
250 |
220 |
$1K |
| 70320 |
|
271 |
219 |
$757.18 |
| 94760 |
|
168 |
124 |
$272.77 |