| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
142 |
62 |
$297.35 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
171 |
66 |
$291.25 |
| J0610 |
Injection, calcium gluconate (fresenius kabi), per 10 ml |
20 |
15 |
$0.83 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
30 |
17 |
$0.00 |
| J7050 |
Infusion, normal saline solution, 250 cc |
170 |
64 |
$0.00 |
| J3490 |
Unclassified drugs |
47 |
15 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
19 |
15 |
$0.00 |
| J7999 |
Compounded drug, not otherwise classified |
19 |
15 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
90 |
36 |
$0.00 |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
20 |
15 |
$0.00 |