| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
3,662 |
3,443 |
$286K |
| 96413 |
|
1,112 |
786 |
$97K |
| 99205 |
Prolong outpt/office vis |
292 |
289 |
$48K |
| 96375 |
|
662 |
470 |
$19K |
| 99213 |
|
287 |
281 |
$15K |
| 96367 |
|
520 |
380 |
$12K |
| 99215 |
Prolong outpt/office vis |
138 |
117 |
$11K |
| 96360 |
|
193 |
129 |
$7K |
| 96374 |
|
139 |
91 |
$5K |
| 96368 |
|
251 |
179 |
$3K |
| 96417 |
|
43 |
36 |
$2K |
| A4221 |
Supp non-insulin inf cath/wk |
109 |
71 |
$2K |
| 99395 |
|
13 |
13 |
$1K |
| S9999 |
Sales tax |
41 |
28 |
$1K |
| J2780 |
Ranitidine hydrochloride inj |
179 |
130 |
$1K |
| J1100 |
Dexamethasone sodium phos |
797 |
556 |
$1K |
| J2469 |
Palonosetron hcl |
76 |
55 |
$871.84 |
| 96415 |
|
14 |
12 |
$411.03 |
| 96361 |
|
36 |
26 |
$354.81 |
| G2012 |
Brief check in by md/qhp |
14 |
13 |
$149.43 |
| J7050 |
Normal saline solution infus |
229 |
164 |
$145.93 |
| J1642 |
Inj heparin sodium per 10 u |
66 |
49 |
$114.57 |
| J1626 |
Granisetron hcl injection |
32 |
24 |
$70.18 |
| J1200 |
Diphenhydramine hcl injectio |
103 |
77 |
$67.93 |
| J3490 |
Drugs unclassified injection |
55 |
42 |
$56.42 |
| J7040 |
Normal saline solution infus |
16 |
12 |
$17.64 |
| S0028 |
Injection, famotidine, 20 mg |
16 |
12 |
$5.65 |