STATE OF SOUTH CAROLINA
NPI: 1003994153
· SUMTER, SC 29150
· 251K00000X
$494K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,512 |
$147K |
| 2019 |
3,436 |
$100K |
| 2020 |
1,911 |
$53K |
| 2021 |
2,262 |
$59K |
| 2022 |
2,142 |
$61K |
| 2023 |
1,127 |
$33K |
| 2024 |
1,460 |
$40K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
3,294 |
3,176 |
$228K |
| 99212 |
|
2,472 |
2,452 |
$69K |
| 99213 |
|
1,379 |
1,359 |
$64K |
| J1050 |
Medroxyprogesterone acetate |
2,195 |
2,181 |
$33K |
| 90460 |
|
1,497 |
1,457 |
$28K |
| 99202 |
|
547 |
542 |
$25K |
| 81025 |
|
3,414 |
3,372 |
$22K |
| 90461 |
|
474 |
470 |
$10K |
| 99204 |
|
64 |
63 |
$7K |
| 99501 |
|
25 |
25 |
$2K |
| Q0111 |
Wet mounts/ w preparations |
687 |
681 |
$2K |
| 99201 |
|
75 |
75 |
$2K |
| S4993 |
Contraceptive pills for bc |
55 |
54 |
$747.63 |
| 90715 |
|
215 |
206 |
$289.86 |
| 90686 |
|
136 |
134 |
$228.08 |
| 90707 |
|
13 |
13 |
$77.05 |
| J0696 |
Ceftriaxone sodium injection |
25 |
24 |
$14.41 |
| 90716 |
|
14 |
14 |
$3.10 |
| 90651 |
|
53 |
53 |
$0.00 |
| 90696 |
|
17 |
17 |
$0.00 |
| 90619 |
|
32 |
25 |
$0.00 |
| 90633 |
|
129 |
127 |
$0.00 |
| 90710 |
|
38 |
38 |
$0.00 |