| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
137 |
135 |
$27K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
101 |
96 |
$24K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
17 |
17 |
$7K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
37 |
37 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
82 |
79 |
$5K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
48 |
15 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
17 |
$2K |
| 80053 |
Comprehensive metabolic panel |
109 |
102 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
138 |
127 |
$1K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
21 |
21 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
12 |
12 |
$941.09 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
12 |
12 |
$614.68 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
46 |
44 |
$439.52 |
| 81001 |
|
100 |
97 |
$425.89 |
| 81025 |
|
43 |
43 |
$368.40 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
20 |
20 |
$240.80 |
| 84484 |
|
14 |
12 |
$220.21 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
34 |
33 |
$212.43 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
21 |
20 |
$184.23 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
21 |
20 |
$125.44 |
| 85730 |
|
13 |
12 |
$116.01 |
| 85610 |
|
13 |
12 |
$76.04 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
16 |
13 |
$67.52 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
32 |
31 |
$42.64 |
| A0425 |
Ground mileage, per statute mile |
12 |
12 |
$37.19 |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
13 |
12 |
$36.18 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
23 |
23 |
$18.24 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
50 |
50 |
$10.02 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
12 |
12 |
$8.55 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
12 |
12 |
$3.66 |