| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99282 |
|
1,481 |
1,151 |
$290K |
| 96361 |
|
698 |
442 |
$247K |
| 99283 |
|
1,935 |
1,447 |
$228K |
| 99284 |
|
1,958 |
1,341 |
$170K |
| 96365 |
|
732 |
391 |
$118K |
| 99214 |
|
2,622 |
2,125 |
$99K |
| 97110 |
|
4,433 |
1,234 |
$86K |
| 99213 |
|
4,915 |
2,817 |
$75K |
| 87637 |
|
751 |
603 |
$66K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
626 |
474 |
$45K |
| 80053 |
|
3,760 |
2,657 |
$23K |
| 99285 |
|
300 |
208 |
$22K |
| 85025 |
|
4,649 |
3,186 |
$18K |
| 11042 |
|
140 |
54 |
$15K |
| 87635 |
|
282 |
243 |
$12K |
| 11043 |
|
34 |
12 |
$9K |
| 93005 |
|
1,266 |
968 |
$8K |
| 84145 |
|
484 |
330 |
$5K |
| 97140 |
|
475 |
152 |
$5K |
| 71046 |
|
325 |
271 |
$5K |
| 80048 |
|
836 |
626 |
$4K |
| 87502 |
|
68 |
61 |
$4K |
| 84484 |
|
536 |
380 |
$3K |
| 87651 |
|
121 |
90 |
$3K |
| 84443 |
|
325 |
248 |
$3K |
| 96372 |
|
376 |
306 |
$3K |
| 99281 |
|
12 |
12 |
$3K |
| 86140 |
|
1,386 |
967 |
$3K |
| 96375 |
|
373 |
241 |
$3K |
| 83036 |
|
304 |
255 |
$2K |
| 96374 |
|
438 |
343 |
$2K |
| A0425 |
Ground mileage, per statute mile |
154 |
131 |
$2K |
| 83735 |
|
608 |
401 |
$2K |
| 93041 |
|
720 |
489 |
$1K |
| 99308 |
|
661 |
576 |
$1K |
| 36415 |
|
5,042 |
3,515 |
$1K |
| 97112 |
|
30 |
12 |
$969.54 |
| 85610 |
|
271 |
220 |
$934.60 |
| 97162 |
|
17 |
13 |
$903.66 |
| 80061 |
|
120 |
87 |
$880.37 |
| 0202U |
|
17 |
15 |
$833.91 |
| 83605 |
|
206 |
139 |
$799.61 |
| A0390 |
Als mileage (per mile) |
29 |
24 |
$737.34 |
| 81015 |
|
636 |
473 |
$705.28 |
| 81003 |
|
354 |
282 |
$434.12 |
| 81001 |
|
298 |
238 |
$382.19 |
| 73630 |
|
19 |
12 |
$360.03 |
| 82550 |
|
53 |
39 |
$170.50 |
| 86756 |
|
45 |
31 |
$161.65 |
| 85730 |
|
68 |
52 |
$140.20 |
| 82553 |
|
31 |
25 |
$138.56 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
500 |
307 |
$132.43 |
| 71045 |
|
42 |
28 |
$116.69 |
| 87086 |
|
33 |
25 |
$108.42 |
| 81007 |
|
51 |
45 |
$108.30 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
50 |
46 |
$73.64 |
| 83690 |
|
21 |
12 |
$71.20 |
| 83550 |
|
16 |
13 |
$64.02 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
190 |
125 |
$58.49 |
| 83540 |
|
16 |
13 |
$48.45 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
115 |
78 |
$13.20 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
45 |
39 |
$0.00 |