| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
299 |
296 |
$36K |
| 95117 |
|
2,812 |
1,590 |
$18K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$938.81 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$625.80 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
14 |
14 |
$404.82 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$322.00 |