| Code | Description | Claims | Beneficiaries | Total Paid |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
123 |
122 |
$9K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
83 |
83 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
74 |
63 |
$2K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
29 |
26 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$839.40 |