| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
550 |
474 |
$110K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
801 |
711 |
$55K |
| 95117 |
|
3,348 |
2,033 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
123 |
119 |
$15K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
89 |
85 |
$8K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
16 |
16 |
$5K |
| G0008 |
Administration of influenza virus vaccine |
27 |
26 |
$596.02 |
| 90686 |
|
15 |
15 |
$165.68 |