| Code | Description | Claims | Beneficiaries | Total Paid |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
183 |
87 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
14 |
14 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
18 |
13 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
14 |
$718.50 |
| Q3014 |
Telehealth originating site facility fee |
36 |
31 |
$672.90 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24 |
17 |
$636.92 |
| 99385 |
|
17 |
17 |
$0.00 |