| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
5,924 |
5,818 |
$2.13M |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
5,287 |
5,070 |
$1.09M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,402 |
9,927 |
$832K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,478 |
3,476 |
$495K |
| 95117 |
|
37,128 |
18,801 |
$412K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,167 |
2,867 |
$316K |
| 94010 |
|
5,301 |
4,698 |
$142K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
733 |
733 |
$77K |
| 95012 |
|
3,351 |
2,985 |
$63K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
830 |
665 |
$11K |
| 96401 |
|
154 |
138 |
$9K |
| 95024 |
|
41 |
41 |
$4K |
| 94060 |
|
61 |
59 |
$3K |
| A4617 |
Mouth piece |
1,462 |
1,328 |
$3K |
| 94664 |
|
89 |
83 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
43 |
43 |
$652.35 |
| 94760 |
|
991 |
831 |
$509.45 |
| 90688 |
|
25 |
25 |
$373.75 |
| 99457 |
|
61 |
47 |
$351.40 |
| 96160 |
|
224 |
210 |
$333.23 |
| 99458 |
|
18 |
15 |
$220.77 |
| 99454 |
|
16 |
13 |
$162.90 |
| J2357 |
Injection, omalizumab, 5 mg |
18 |
17 |
$0.01 |
| 99070 |
|
118 |
114 |
$0.00 |