| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
726 |
658 |
$153K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,045 |
941 |
$127K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
670 |
574 |
$112K |
| A0425 |
Ground mileage, per statute mile |
1,942 |
1,455 |
$92K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
219 |
178 |
$31K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
575 |
430 |
$25K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
159 |
144 |
$14K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
129 |
118 |
$5K |
| 87631 |
|
25 |
25 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,321 |
1,868 |
$3K |
| 80053 |
Comprehensive metabolic panel |
1,825 |
1,522 |
$2K |
| 0001A |
|
69 |
69 |
$701.12 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
176 |
151 |
$305.35 |
| A0398 |
Als routine disposable supplies |
13 |
12 |
$162.63 |
| 84443 |
Thyroid stimulating hormone (TSH) |
222 |
217 |
$151.52 |
| 71045 |
Radiologic examination, chest; single view |
30 |
25 |
$101.93 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
128 |
109 |
$101.20 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
50 |
$100.54 |
| 36415 |
Collection of venous blood by venipuncture |
963 |
773 |
$74.53 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$42.95 |
| 81001 |
|
384 |
342 |
$30.38 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
129 |
119 |
$22.10 |
| 80061 |
Lipid panel |
99 |
99 |
$18.10 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
42 |
41 |
$13.31 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
14 |
12 |
$8.85 |
| 81003 |
|
29 |
26 |
$4.88 |
| A9270 |
Non-covered item or service |
1,140 |
572 |
$2.38 |
| T1015 |
Clinic visit/encounter, all-inclusive |
547 |
424 |
$0.01 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
73 |
65 |
$0.00 |
| 91300 |
|
68 |
67 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
18 |
13 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
30 |
24 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
16 |
12 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
13 |
13 |
$0.00 |