| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
393 |
389 |
$88K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
381 |
376 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
423 |
423 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
312 |
268 |
$23K |
| 95117 |
|
823 |
316 |
$6K |
| 3074F |
|
392 |
352 |
$0.00 |
| 3079F |
|
28 |
27 |
$0.00 |
| 3078F |
|
204 |
187 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
67 |
65 |
$0.00 |