| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,273 |
3,119 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
215 |
209 |
$1K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
60 |
24 |
$209.29 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
31 |
12 |
$115.00 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
31 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
81 |
37 |
$0.00 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
63 |
24 |
$0.00 |