| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
514 |
349 |
$49K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
243 |
125 |
$25K |
| 96367 |
|
63 |
27 |
$3K |
| 96417 |
|
58 |
40 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
26 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 96368 |
|
96 |
47 |
$1K |
| 96415 |
|
19 |
13 |
$970.52 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
207 |
99 |
$467.09 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
185 |
87 |
$272.63 |