| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,927 |
3,912 |
$166K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
198 |
42 |
$58K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
369 |
360 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
362 |
332 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
266 |
247 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,090 |
863 |
$16K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
27 |
27 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
91 |
91 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
92 |
89 |
$5K |
| 90461 |
|
579 |
408 |
$3K |
| 90658 |
|
64 |
53 |
$0.02 |
| 90670 |
|
155 |
154 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90648 |
|
27 |
27 |
$0.00 |
| 90633 |
|
31 |
31 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |