| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0013 |
Esketamine, nasal spray, 1 mg |
773 |
146 |
$746K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,415 |
3,248 |
$111K |
| 99215 |
Prolong outpt/office vis |
845 |
153 |
$73K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
724 |
512 |
$30K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,042 |
1,037 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
58 |
57 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
42 |
35 |
$563.54 |
| 99417 |
Prolong home eval add 15m |
37 |
12 |
$0.00 |