| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1756 |
Injection, iron sucrose, 1 mg |
123 |
52 |
$5K |
| 96367 |
|
188 |
80 |
$5K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
126 |
54 |
$4K |
| 99205 |
Prolong outpt/office vis |
25 |
25 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
185 |
79 |
$901.43 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
24 |
$482.30 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
185 |
79 |
$157.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
12 |
$23.50 |