| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
541 |
508 |
$49K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
270 |
257 |
$36K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
397 |
370 |
$27K |
| 95117 |
|
1,122 |
552 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73 |
68 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
79 |
74 |
$7K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
14 |
14 |
$4K |
| 94010 |
|
120 |
111 |
$2K |
| 94060 |
|
12 |
12 |
$394.57 |