| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
1,007 |
978 |
$148K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
4,445 |
2,086 |
$121K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,157 |
1,075 |
$85K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
409 |
407 |
$47K |
| 95117 |
|
4,681 |
2,173 |
$46K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
865 |
797 |
$43K |
| 94010 |
|
561 |
528 |
$15K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
60 |
60 |
$4K |
| 95012 |
|
243 |
225 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
12 |
$402.42 |
| A4617 |
Mouth piece |
57 |
57 |
$189.90 |