| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,821 |
11,511 |
$1.31M |
| 99417 |
Prolong home eval add 15m |
3,644 |
842 |
$760K |
| 99215 |
Prolong outpt/office vis |
5,259 |
1,948 |
$619K |
| S0013 |
Esketamine, nasal spray, 1 mg |
269 |
74 |
$245K |
| 17999 |
|
709 |
365 |
$185K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,352 |
1,230 |
$81K |
| 99406 |
|
5,929 |
4,541 |
$61K |
| 99355 |
|
356 |
91 |
$32K |
| 99442 |
|
550 |
452 |
$23K |
| 99354 |
|
376 |
101 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,258 |
1,143 |
$15K |
| 99443 |
|
141 |
137 |
$9K |
| 99205 |
Prolong outpt/office vis |
24 |
24 |
$4K |
| 99051 |
|
571 |
510 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
12 |
$2K |
| 93000 |
|
130 |
115 |
$2K |
| 96127 |
|
32 |
27 |
$468.00 |
| 90688 |
|
25 |
25 |
$457.93 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
63 |
$26.28 |