| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
136 |
52 |
$12K |
| 96365 |
|
139 |
49 |
$4K |
| 96374 |
|
145 |
53 |
$4K |
| 99417 |
Prolong home eval add 15m |
71 |
28 |
$4K |
| 93041 |
|
143 |
53 |
$455.46 |
| A4670 |
Automatic bp monitor, dial |
92 |
39 |
$214.35 |
| A4222 |
Infusion supplies with pump |
92 |
39 |
$204.87 |
| J7040 |
Normal saline solution infus |
123 |
41 |
$94.97 |
| E0780 |
Mech amb infusion pump <8hrs |
148 |
52 |
$29.34 |
| J3475 |
Inj magnesium sulfate |
40 |
15 |
$26.28 |
| A4628 |
Oropharyngeal suction cath |
148 |
52 |
$10.47 |
| J2405 |
Ondansetron hcl injection |
22 |
14 |
$3.84 |
| A4216 |
Sterile water/saline, 10 ml |
149 |
53 |
$1.47 |
| J3490 |
Drugs unclassified injection |
120 |
41 |
$0.03 |
| E1399 |
Durable medical equipment mi |
119 |
40 |
$0.00 |
| A4208 |
3 cc sterile syringe&needle |
148 |
52 |
$0.00 |