| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2323 |
Injection, natalizumab, 1 mg |
802 |
540 |
$5.01M |
| J2350 |
Injection, ocrelizumab, 1 mg |
148 |
132 |
$3.90M |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,535 |
729 |
$331K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,158 |
3,990 |
$248K |
| 96415 |
|
214 |
193 |
$121K |
| 96367 |
|
137 |
120 |
$71K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
572 |
526 |
$59K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
73 |
64 |
$41K |
| 99215 |
Prolong outpt/office vis |
225 |
208 |
$21K |
| 99205 |
Prolong outpt/office vis |
108 |
105 |
$19K |
| 93042 |
|
4,175 |
3,131 |
$18K |
| 95951 |
|
28 |
13 |
$9K |
| 95816 |
|
218 |
209 |
$8K |
| 95720 |
|
66 |
39 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
31 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63 |
63 |
$4K |
| 64615 |
|
12 |
12 |
$1K |
| 95819 |
|
27 |
26 |
$785.08 |
| 93880 |
|
12 |
12 |
$422.79 |
| 95886 |
|
13 |
13 |
$218.70 |
| 95885 |
|
14 |
14 |
$165.56 |
| 93040 |
|
12 |
12 |
$125.84 |
| 99443 |
|
79 |
79 |
$0.00 |