| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
83 |
79 |
$6K |
| 95117 |
|
1,340 |
810 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
68 |
68 |
$3K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
62 |
60 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
83 |
67 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
125 |
103 |
$737.70 |
| 95115 |
|
102 |
63 |
$283.87 |
| J2357 |
Injection, omalizumab, 5 mg |
32 |
30 |
$0.00 |