| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
197 |
182 |
$37K |
| 95117 |
|
2,826 |
1,173 |
$34K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
120 |
113 |
$17K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
62 |
25 |
$14K |
| 99072 |
|
487 |
220 |
$4K |
| 94010 |
|
138 |
106 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
46 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$1K |
| 0031A |
|
39 |
39 |
$1K |
| 96160 |
|
25 |
24 |
$39.76 |
| 91303 |
|
38 |
38 |
$0.32 |