| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
850 |
644 |
$135K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
862 |
624 |
$73K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
879 |
620 |
$50K |
| Z1034 |
|
589 |
396 |
$32K |
| Z1032 |
|
136 |
136 |
$21K |
| J3490 |
Unclassified drugs |
177 |
133 |
$18K |
| Z6500 |
|
136 |
136 |
$17K |
| A4267 |
Contraceptive supply, condom, male, each |
1,134 |
1,119 |
$13K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
736 |
736 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
142 |
135 |
$9K |
| 99381 |
|
74 |
74 |
$5K |
| Z6400 |
|
302 |
275 |
$5K |
| Z6406 |
|
297 |
244 |
$4K |
| Z6204 |
|
258 |
216 |
$3K |
| 99201 |
|
34 |
17 |
$3K |
| Z6410 |
|
146 |
118 |
$3K |
| 81025 |
|
868 |
867 |
$2K |
| 99402 |
|
55 |
55 |
$2K |
| Z6304 |
|
171 |
146 |
$2K |
| 90670 |
|
82 |
81 |
$733.50 |
| 90647 |
|
65 |
65 |
$571.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
14 |
$473.84 |
| 90713 |
|
48 |
48 |
$432.00 |
| 90700 |
|
48 |
48 |
$429.75 |
| S0197 |
Prenatal vitamins, 30-day supply |
270 |
137 |
$409.37 |
| 90744 |
|
28 |
28 |
$249.75 |
| 90680 |
|
16 |
16 |
$144.00 |
| 92551 |
|
12 |
12 |
$126.98 |
| 90723 |
|
13 |
13 |
$117.00 |
| 90633 |
|
13 |
13 |
$112.50 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
21 |
16 |
$0.00 |
| 59425 |
|
31 |
19 |
$0.00 |