| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
835 |
726 |
$425K |
| J2357 |
Injection, omalizumab, 5 mg |
109 |
86 |
$242K |
| 95117 |
|
19,644 |
10,964 |
$175K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
359 |
356 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
581 |
572 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
331 |
329 |
$21K |
| 96401 |
|
93 |
76 |
$11K |
| 94010 |
|
131 |
129 |
$4K |
| 95024 |
|
16 |
16 |
$3K |
| 95012 |
|
80 |
79 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$965.28 |