| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
444 |
418 |
$21K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
1,012 |
249 |
$15K |
| 99215 |
Prolong outpt/office vis |
86 |
83 |
$6K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
834 |
157 |
$5K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
81 |
40 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
34 |
12 |
$558.37 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
97 |
56 |
$194.93 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
185 |
80 |
$51.92 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
166 |
75 |
$11.43 |