| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,315 |
622 |
$97K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
264 |
165 |
$36K |
| Z1034 |
|
331 |
212 |
$18K |
| Z1032 |
|
78 |
78 |
$12K |
| Z6500 |
|
85 |
85 |
$11K |
| J3490 |
Unclassified drugs |
118 |
59 |
$10K |
| A4267 |
Contraceptive supply, condom, male, each |
473 |
472 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
69 |
69 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
112 |
98 |
$3K |
| Z6400 |
|
238 |
192 |
$3K |
| 99381 |
|
55 |
55 |
$2K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
163 |
163 |
$2K |
| 81025 |
|
662 |
655 |
$2K |
| Z6204 |
|
147 |
116 |
$2K |
| Z6406 |
|
150 |
121 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
38 |
$1K |
| Z6410 |
|
71 |
59 |
$633.62 |
| Z6304 |
|
69 |
65 |
$551.11 |
| 90700 |
|
46 |
46 |
$405.02 |
| 90670 |
|
46 |
46 |
$369.00 |
| 90713 |
|
42 |
42 |
$369.00 |
| 90680 |
|
38 |
38 |
$342.00 |
| 90743 |
|
31 |
31 |
$279.00 |
| 90647 |
|
36 |
36 |
$270.00 |
| S0197 |
Prenatal vitamins, 30-day supply |
173 |
89 |
$234.53 |
| 81002 |
|
98 |
95 |
$186.25 |
| Z6414 |
|
14 |
13 |
$174.11 |