| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,868 |
1,327 |
$52K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,001 |
1,400 |
$7K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
37 |
24 |
$2K |
| 96367 |
|
57 |
37 |
$1K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
127 |
63 |
$807.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
25 |
$395.60 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
20 |
12 |
$301.18 |
| J7050 |
Infusion, normal saline solution, 250 cc |
61 |
37 |
$105.48 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
32 |
24 |
$14.64 |