| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
391 |
42 |
$110K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
934 |
844 |
$76K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,160 |
1,073 |
$65K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
819 |
809 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
322 |
314 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
270 |
269 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
225 |
220 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
153 |
153 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
318 |
199 |
$12K |
| 92551 |
|
598 |
549 |
$4K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
13 |
13 |
$3K |
| 95117 |
|
228 |
102 |
$2K |
| 81002 |
|
599 |
570 |
$2K |
| 90461 |
|
322 |
269 |
$2K |
| 99173 |
|
599 |
538 |
$993.16 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
32 |
$790.58 |
| 96127 |
|
23 |
23 |
$81.28 |
| 94760 |
|
26 |
19 |
$12.76 |
| 99000 |
|
14 |
12 |
$10.00 |
| 90670 |
|
90 |
89 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90700 |
|
26 |
24 |
$0.00 |
| 90713 |
|
14 |
12 |
$0.00 |
| 90649 |
|
12 |
12 |
$0.00 |
| 90686 |
|
145 |
145 |
$0.00 |