| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,063 |
409 |
$29K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
668 |
287 |
$21K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
754 |
310 |
$15K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
366 |
219 |
$14K |
| 93000 |
|
257 |
223 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
30 |
$3K |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
196 |
123 |
$3K |
| 81003 |
|
1,225 |
413 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
47 |
39 |
$2K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
732 |
273 |
$1K |
| 80053 |
Comprehensive metabolic panel |
151 |
98 |
$1K |
| J3411 |
Injection, thiamine hcl, 100 mg |
603 |
284 |
$1K |
| J3490 |
Unclassified drugs |
101 |
56 |
$938.18 |
| S0028 |
Injection, famotidine, 20 mg |
849 |
331 |
$489.31 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
187 |
115 |
$390.19 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
955 |
341 |
$218.91 |
| J7999 |
Compounded drug, not otherwise classified |
132 |
77 |
$0.00 |