| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
82 |
82 |
$171K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
456 |
422 |
$42K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
115 |
114 |
$31K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
126 |
126 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
371 |
329 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
129 |
116 |
$11K |
| 99386 |
|
67 |
67 |
$9K |
| 76830 |
Ultrasound, transvaginal |
113 |
113 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
116 |
104 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
71 |
71 |
$5K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
282 |
281 |
$4K |
| 99385 |
|
35 |
35 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$2K |
| 81025 |
|
144 |
140 |
$489.25 |
| 81002 |
|
222 |
218 |
$359.91 |
| 99051 |
|
35 |
27 |
$221.20 |
| 83986 |
|
41 |
40 |
$55.72 |
| 36415 |
Collection of venous blood by venipuncture |
183 |
181 |
$9.35 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
189 |
189 |
$0.00 |