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Coding Z02.2 with a primary diagnosis code: When the sole purpose of the encounter is the pre-admission exam, Z02.2 is the first-listed diagnosis

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Cost sharing for model drugs will be limited to $245 for a 30-day supply in the deductible phase and a lower amount in the initial coverage phase: $50 per month for enhanced plans and employer group plans and $125 per month for basic plans (though plan sponsors can choose to apply lower cost-sharing amounts to model drugs as long as they do so uniformly across all model drugs)