| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,558 |
4,198 |
$447K |
| Z1034 |
|
4,067 |
2,655 |
$224K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
700 |
700 |
$129K |
| Z1032 |
|
709 |
709 |
$111K |
| J3490 |
Unclassified drugs |
1,178 |
1,103 |
$97K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,454 |
1,430 |
$95K |
| Z6500 |
|
370 |
370 |
$46K |
| A4267 |
Contraceptive supply, condom, male, each |
2,957 |
2,945 |
$33K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
424 |
424 |
$22K |
| 81025 |
|
6,709 |
6,438 |
$21K |
| 99000 |
|
5,727 |
5,299 |
$19K |
| Z6400 |
|
1,476 |
1,235 |
$17K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
323 |
232 |
$12K |
| 81002 |
|
4,406 |
2,911 |
$8K |
| Z6406 |
|
708 |
635 |
$8K |
| Z6204 |
|
738 |
664 |
$6K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
413 |
412 |
$5K |
| Z6410 |
|
569 |
438 |
$5K |
| Z6304 |
|
322 |
316 |
$3K |
| Z1038 |
|
27 |
27 |
$1K |
| S0197 |
Prenatal vitamins, 30-day supply |
817 |
738 |
$1K |
| Z6412 |
|
24 |
24 |
$472.13 |
| Z6414 |
|
28 |
28 |
$426.94 |
| Z6308 |
|
28 |
28 |
$213.48 |
| Z6208 |
|
28 |
28 |
$213.48 |
| 81000 |
|
32 |
31 |
$79.96 |
| 0502F |
|
20 |
14 |
$0.00 |