| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
665 |
189 |
$290K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
178 |
177 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
907 |
792 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
477 |
472 |
$44K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
290 |
290 |
$28K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
296 |
296 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
291 |
291 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
61 |
59 |
$5K |
| 76830 |
Ultrasound, transvaginal |
48 |
46 |
$4K |
| 88150 |
|
356 |
356 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$2K |
| 82270 |
|
358 |
358 |
$1K |
| 81002 |
|
505 |
501 |
$1K |
| 99401 |
|
68 |
65 |
$1K |
| 83986 |
|
227 |
227 |
$473.35 |
| 82120 |
|
76 |
75 |
$246.91 |