| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
4,228 |
1,179 |
$432K |
| 99417 |
Prolong home eval add 15m |
4,210 |
936 |
$328K |
| 99153 |
Mod sedat endo service >5yrs |
7,039 |
1,051 |
$253K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
4,339 |
1,248 |
$225K |
| 99152 |
|
4,190 |
1,058 |
$175K |
| J3490 |
Unclassified drugs |
6,143 |
1,189 |
$108K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
3,542 |
912 |
$84K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
4,287 |
1,242 |
$72K |
| 93790 |
|
3,955 |
1,111 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
884 |
757 |
$55K |
| 93040 |
|
4,468 |
1,308 |
$47K |
| 95816 |
|
145 |
141 |
$46K |
| 99424 |
|
547 |
543 |
$37K |
| 99457 |
|
1,142 |
1,096 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
679 |
555 |
$32K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
381 |
357 |
$31K |
| 99454 |
|
822 |
794 |
$27K |
| 99425 |
|
380 |
377 |
$26K |
| 99484 |
|
872 |
830 |
$23K |
| 99458 |
|
859 |
823 |
$22K |
| 95957 |
|
101 |
97 |
$22K |
| 93923 |
|
217 |
207 |
$21K |
| A4930 |
Gloves, sterile, per pair |
3,036 |
442 |
$21K |
| 36410 |
|
1,751 |
513 |
$19K |
| 96132 |
|
158 |
152 |
$15K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
4,758 |
1,312 |
$11K |
| 92653 |
|
125 |
123 |
$9K |
| 96368 |
|
508 |
496 |
$8K |
| 95930 |
|
146 |
142 |
$8K |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
551 |
526 |
$6K |
| 96139 |
|
147 |
139 |
$4K |
| 96138 |
|
146 |
138 |
$4K |
| 92650 |
|
92 |
90 |
$3K |
| A4615 |
Cannula, nasal |
2,783 |
872 |
$3K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
3,900 |
995 |
$1K |
| 99453 |
|
107 |
104 |
$1K |
| 96136 |
|
25 |
25 |
$995.36 |
| 96137 |
|
26 |
26 |
$952.21 |
| J0613 |
Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg |
1,471 |
706 |
$870.32 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
2,213 |
572 |
$363.58 |
| 36000 |
|
106 |
45 |
$60.28 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
32 |
12 |
$11.53 |
| J1920 |
Injection, labetalol hydrochloride, 5 mg |
22 |
12 |
$4.52 |
| 3028F |
|
611 |
191 |
$0.41 |
| 99070 |
|
13 |
12 |
$0.00 |