| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
639 |
545 |
$19K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
411 |
363 |
$16K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
57 |
56 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41 |
40 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$235.50 |
| 87081 |
|
12 |
12 |
$69.60 |