| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
560 |
239 |
$68K |
| 99417 |
Prolong home eval add 15m |
333 |
141 |
$35K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
238 |
121 |
$11K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
304 |
146 |
$10K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
14 |
14 |
$3K |
| 96127 |
|
238 |
121 |
$1K |
| 93041 |
|
238 |
121 |
$959.72 |
| 36000 |
|
74 |
42 |
$839.85 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
166 |
84 |
$98.71 |