| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
5,175 |
334 |
$290K |
| 95117 |
|
1,422 |
164 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
13 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,085 |
663 |
$498.45 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,121 |
667 |
$124.20 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
166 |
113 |
$49.28 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,117 |
666 |
$42.51 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
12 |
$34.32 |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
1,084 |
657 |
$29.66 |
| S1016 |
Non-pvc (polyvinyl chloride) intravenous administration set, for use with drugs that are not stable in pvc e.g., paclitaxel |
1,082 |
655 |
$8.10 |
| S1015 |
Iv tubing extension set |
1,083 |
656 |
$8.10 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
1,099 |
667 |
$1.35 |
| J3490 |
Unclassified drugs |
7,464 |
655 |
$0.17 |
| E0776 |
Iv pole |
1,085 |
656 |
$0.00 |
| 2001F |
|
63 |
47 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
38 |
29 |
$0.00 |
| 2010F |
|
229 |
164 |
$0.00 |
| J1270 |
Injection, doxercalciferol, 1 mcg |
178 |
120 |
$0.00 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
1,087 |
657 |
$0.00 |