| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
14 |
12 |
$65K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
55 |
44 |
$10K |
| 99233 |
Prolong inpt eval add15 m |
65 |
14 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
46 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
98 |
90 |
$5K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
16 |
13 |
$4K |
| 85651 |
|
14 |
12 |
$3K |
| 80053 |
Comprehensive metabolic panel |
14 |
14 |
$270.71 |