| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0013 |
Esketamine, nasal spray, 1 mg |
1,593 |
558 |
$1.29M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,019 |
415 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
609 |
271 |
$21K |
| G2083 |
Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observation |
99 |
39 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
42 |
26 |
$1K |