| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96361 |
Intravenous infusion, hydration; each additional hour |
29 |
25 |
$1K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
28 |
24 |
$786.60 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21 |
17 |
$308.88 |
| J2780 |
Injection, ranitidine hydrochloride, 25 mg |
201 |
76 |
$264.25 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
199 |
79 |
$80.59 |
| J7050 |
Infusion, normal saline solution, 250 cc |
200 |
77 |
$28.48 |
| 36415 |
Collection of venous blood by venipuncture |
18 |
18 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
23 |
19 |
$0.00 |