| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,343 |
1,129 |
$211K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
312 |
267 |
$94K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
855 |
205 |
$65K |
| 80053 |
Comprehensive metabolic panel |
789 |
622 |
$33K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,166 |
918 |
$30K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
62 |
51 |
$18K |
| J3490 |
Unclassified drugs |
908 |
394 |
$18K |
| 36415 |
Collection of venous blood by venipuncture |
1,790 |
1,317 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
387 |
357 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
113 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
175 |
165 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
171 |
148 |
$8K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
56 |
54 |
$7K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
58 |
51 |
$6K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
67 |
64 |
$5K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
85 |
78 |
$5K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
656 |
279 |
$5K |
| 81001 |
|
324 |
274 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
116 |
95 |
$4K |
| 81003 |
|
247 |
203 |
$4K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
142 |
126 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
124 |
117 |
$4K |
| 84145 |
|
20 |
17 |
$2K |
| 87400 |
|
16 |
15 |
$2K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
14 |
12 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
32 |
29 |
$2K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
34 |
24 |
$2K |
| A0425 |
Ground mileage, per statute mile |
18 |
15 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
33 |
25 |
$777.77 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
20 |
14 |
$760.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
14 |
12 |
$748.45 |
| 84484 |
|
13 |
13 |
$676.67 |
| Q3014 |
Telehealth originating site facility fee |
14 |
14 |
$648.24 |
| 86140 |
|
19 |
13 |
$526.48 |
| A9150 |
Non-prescription drugs |
27 |
26 |
$0.00 |