| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
1,261 |
1,258 |
$318K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,149 |
3,731 |
$241K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
1,642 |
1,629 |
$163K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,275 |
1,275 |
$160K |
| 95117 |
|
11,973 |
7,131 |
$92K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
642 |
642 |
$55K |
| 94010 |
|
1,316 |
1,254 |
$31K |
| 95012 |
|
1,160 |
1,108 |
$15K |
| 99457 |
|
263 |
238 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
745 |
614 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
74 |
73 |
$6K |
| 99458 |
|
122 |
110 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
59 |
59 |
$2K |
| A4617 |
Mouth piece |
987 |
943 |
$2K |
| 99454 |
|
17 |
15 |
$907.12 |
| 96160 |
|
341 |
331 |
$530.42 |
| 99453 |
|
18 |
15 |
$276.25 |
| J2357 |
Injection, omalizumab, 5 mg |
164 |
145 |
$0.36 |
| J3590 |
Unclassified biologics |
36 |
25 |
$0.11 |
| 94760 |
|
31 |
29 |
$0.00 |
| 99070 |
|
126 |
121 |
$0.00 |