| CPT |
Description |
Number of Claims |
Sum Performed |
|
J1459
|
INJ IVIG PRIVIGEN 500 MG |
25
|
1,540
|
|
G0463
|
HOSPITAL OUTPT CLINIC VISIT |
24
|
24
|
|
J1200
|
DIPHENHYDRAMINE HCL INJECTIO |
16
|
16
|
|
A9270
|
NON-COVERED ITEM OR SERVICE |
15
|
30
|
|
96375
|
TX/PRO/DX INJ NEW DRUG ADDON |
15
|
18
|
|
96366
|
THER/PROPH/DIAG IV INF ADDON |
15
|
66
|
|
96365
|
THER/PROPH/DIAG IV INF INIT |
15
|
17
|
|
J1642
|
INJ HEPARIN SODIUM PER 10 U |
14
|
700
|
|
36415
|
COLL VENOUS BLD VENIPUNCTURE |
12
|
12
|
|
85025
|
COMPLETE CBC W/AUTO DIFF WBC |
12
|
12
|
|
80053
|
COMPREHEN METABOLIC PANEL |
10
|
10
|
|
Q9967
|
LOCM 300-399MG/ML IODINE,1ML |
7
|
688
|
|
71260
|
CT THORAX DX C+ |
6
|
6
|
|
74177
|
CT ABD & PELVIS W/CONTRAST |
6
|
6
|
|
83615
|
LACTATE (LD) (LDH) ENZYME |
5
|
5
|
|
G1004
|
CDSM NDSC |
5
|
7
|
|
84165
|
PROTEIN E-PHORESIS SERUM |
2
|
2
|
|
83036
|
HEMOGLOBIN GLYCOSYLATED A1C |
2
|
2
|
|
71250
|
CT THORAX DX C- |
2
|
2
|
|
Q3014
|
TELEHEALTH FACILITY FEE |
2
|
2
|
