| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,662 |
3,443 |
$286K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,112 |
786 |
$97K |
| 99205 |
Prolong outpt/office vis |
292 |
289 |
$48K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
662 |
470 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
287 |
281 |
$15K |
| 96367 |
|
520 |
380 |
$12K |
| 99215 |
Prolong outpt/office vis |
138 |
117 |
$11K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
193 |
129 |
$7K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
139 |
91 |
$5K |
| 96368 |
|
251 |
179 |
$3K |
| 96417 |
|
43 |
36 |
$2K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
109 |
71 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| S9999 |
Sales tax |
41 |
28 |
$1K |
| J2780 |
Injection, ranitidine hydrochloride, 25 mg |
179 |
130 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
797 |
556 |
$1K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
76 |
55 |
$871.84 |
| 96415 |
|
14 |
12 |
$411.03 |
| 96361 |
Intravenous infusion, hydration; each additional hour |
36 |
26 |
$354.81 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
14 |
13 |
$149.43 |
| J7050 |
Infusion, normal saline solution, 250 cc |
229 |
164 |
$145.93 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
66 |
49 |
$114.57 |
| J1626 |
Injection, granisetron hydrochloride, 100 mcg |
32 |
24 |
$70.18 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
103 |
77 |
$67.93 |
| J3490 |
Unclassified drugs |
55 |
42 |
$56.42 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
16 |
12 |
$17.64 |
| S0028 |
Injection, famotidine, 20 mg |
16 |
12 |
$5.65 |