| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
176 |
167 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
272 |
253 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
255 |
242 |
$20K |
| 95117 |
|
1,121 |
599 |
$11K |
| 99205 |
Prolong outpt/office vis |
47 |
40 |
$9K |
| 94010 |
|
285 |
263 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
44 |
41 |
$6K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
22 |
22 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$1K |
| 95115 |
|
13 |
12 |
$120.88 |