| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
363 |
153 |
$108K |
| 95117 |
|
5,945 |
2,408 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
159 |
143 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
71 |
70 |
$11K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
42 |
39 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
153 |
132 |
$10K |
| 94375 |
|
160 |
154 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
52 |
37 |
$3K |
| A4617 |
Mouth piece |
245 |
214 |
$349.13 |