| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
146 |
131 |
$30K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
115 |
104 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
184 |
170 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
136 |
136 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
118 |
107 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$3K |
| 95115 |
|
369 |
157 |
$2K |
| 95117 |
|
164 |
64 |
$1K |