| Code | Description | Claims | Beneficiaries | Total Paid |
| 96401 |
|
373 |
294 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
319 |
302 |
$17K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
12 |
12 |
$2K |
| 95117 |
|
239 |
119 |
$1K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
15 |
15 |
$585.93 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$448.85 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$367.50 |
| 94760 |
|
27 |
25 |
$2.08 |