| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,731 |
1,464 |
$104K |
| 99215 |
Prolong outpt/office vis |
734 |
525 |
$62K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
837 |
576 |
$61K |
| J1602 |
Injection, golimumab, 1 mg, for intravenous use |
13 |
12 |
$19K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,160 |
856 |
$7K |
| 80053 |
Comprehensive metabolic panel |
674 |
491 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
111 |
93 |
$4K |
| 96367 |
|
133 |
100 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
182 |
133 |
$2K |
| 96415 |
|
15 |
12 |
$224.50 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
120 |
62 |
$105.43 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
12 |
$86.56 |
| J7050 |
Infusion, normal saline solution, 250 cc |
121 |
91 |
$61.51 |
| A4550 |
Surgical trays |
281 |
168 |
$11.56 |
| J3490 |
Unclassified drugs |
164 |
142 |
$0.00 |