| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95117 |
|
3,368 |
1,244 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
166 |
166 |
$533.98 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
29 |
$75.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44 |
42 |
$48.00 |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
35 |
26 |
$0.00 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
13 |
12 |
$0.00 |