| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,825 |
1,461 |
$45K |
| 96367 |
|
508 |
287 |
$16K |
| 99233 |
Prolong inpt eval add15 m |
226 |
52 |
$9K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
617 |
368 |
$6K |
| 99223 |
Prolong inpt eval add15 m |
54 |
48 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
46 |
$2K |
| 96417 |
|
189 |
131 |
$2K |
| 96415 |
|
132 |
94 |
$2K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
195 |
131 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
47 |
28 |
$183.21 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
60 |
40 |
$10.37 |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
18 |
12 |
$0.01 |