| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
2,256 |
2,112 |
$280K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,890 |
2,627 |
$153K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
395 |
269 |
$121K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,431 |
1,335 |
$107K |
| 95117 |
|
10,002 |
3,273 |
$87K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
426 |
413 |
$46K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
625 |
583 |
$45K |
| 95115 |
|
2,101 |
652 |
$14K |
| 96401 |
|
282 |
145 |
$13K |
| 95024 |
|
161 |
150 |
$9K |
| 94010 |
|
160 |
147 |
$3K |
| J2357 |
Injection, omalizumab, 5 mg |
17 |
12 |
$0.00 |