| Code | Description | Total Paid |
| S5102 |
Day care services, adult; per diem |
$1.63M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
$1.31M |
| 41899 |
Unlisted procedure, dentoalveolar structures |
$811K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
$705K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
$483K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
$319K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
$317K |
| G0378 |
Hospital observation service, per hour |
$221K |
| 93000 |
|
$202K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
$202K |