| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2357 |
Injection, omalizumab, 5 mg |
606 |
473 |
$1.17M |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
5,644 |
2,413 |
$935K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
2,102 |
1,890 |
$394K |
| 95117 |
|
22,690 |
9,694 |
$328K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,395 |
4,000 |
$226K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,105 |
2,949 |
$99K |
| 96401 |
|
1,078 |
762 |
$74K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
664 |
597 |
$58K |
| 94060 |
|
1,154 |
1,090 |
$48K |
| 95024 |
|
562 |
516 |
$35K |
| 96160 |
|
1,648 |
1,572 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
96 |
90 |
$7K |
| A4617 |
Mouth piece |
873 |
834 |
$3K |
| 95012 |
|
40 |
40 |
$522.36 |
| 94664 |
|
14 |
14 |
$168.00 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$36.67 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
12 |
$3.77 |
| 99072 |
|
14 |
14 |
$0.00 |