| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
2,292 |
1,557 |
$147K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
668 |
564 |
$24K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
392 |
238 |
$12K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
69 |
36 |
$369.12 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
49 |
24 |
$311.20 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$237.60 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
27 |
12 |
$208.20 |