| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
84 |
32 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
268 |
212 |
$10K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
20 |
20 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
63 |
61 |
$3K |
| 95018 |
|
19 |
19 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
23 |
20 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
20 |
$2K |
| 95076 |
|
20 |
20 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
46 |
$180.00 |
| 93000 |
|
32 |
31 |
$94.50 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$30.00 |