| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
35 |
30 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
362 |
216 |
$7K |
| 95117 |
|
340 |
201 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
43 |
$2K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
15 |
15 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 95115 |
|
60 |
40 |
$391.25 |