| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,784 |
4,356 |
$289K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
417 |
81 |
$47K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
202 |
144 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
521 |
420 |
$23K |
| 99199 |
Unlisted special service, procedure or report |
4,134 |
4,091 |
$14K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
119 |
40 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
49 |
32 |
$1K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
84 |
27 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
28 |
24 |
$1K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
117 |
40 |
$1K |
| 36000 |
|
119 |
39 |
$952.50 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
93 |
81 |
$929.63 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
73 |
26 |
$729.74 |
| 82947 |
|
530 |
439 |
$603.52 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
174 |
148 |
$597.81 |
| 81003 |
|
336 |
250 |
$416.33 |
| 90686 |
|
52 |
50 |
$397.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
36 |
$319.71 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
71 |
27 |
$178.76 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
369 |
307 |
$53.25 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
101 |
38 |
$13.73 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
79 |
39 |
$12.16 |
| 85018 |
|
12 |
12 |
$8.76 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
87 |
51 |
$7.22 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
115 |
47 |
$4.44 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
35 |
12 |
$1.00 |
| J3490 |
Unclassified drugs |
96 |
38 |
$0.00 |
| G0483 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed |
17 |
13 |
$0.00 |