MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC.

$470K

Total Medicaid Paid

13,998

Total Claims

12,287

Beneficiaries

23

Codes Billed

2018-01

First Month

2019-12

Last Month

Authorized Official	KENNEY, TANYA (MMCFPP MANAGER)
NPI Enumeration Date	05/26/2006

Year	Claims	Total Paid
2018	7,350	$307K
2019	6,648	$163K

Code	Description	Claims	Beneficiaries	Total Paid
59409	Vaginal delivery only (with or without episiotomy and/or forceps)	357	355	$203K
99232	Subsequent hospital care, per day, moderate complexity	1,525	758	$45K
77067	Screening mammography, bilateral, including computer-aided detection	1,914	1,914	$37K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	710	677	$35K
59514		42	42	$30K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1,202	1,169	$26K
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	6,016	5,250	$24K
99222	Initial hospital care, per day, moderate complexity	233	231	$14K
99238	Hospital discharge day management, 30 minutes or less	357	351	$14K
77063	Screening digital breast tomosynthesis, bilateral	524	524	$8K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	230	230	$7K
54150		57	57	$6K
76819	Fetal biophysical profile; without non-stress testing	162	146	$5K
76816	Ultrasound, pregnant uterus, real time with image documentation, follow-up	101	96	$3K
76642		157	136	$2K
99460		45	45	$2K
99223	Prolong inpt eval add15 m	33	32	$2K
99233	Prolong inpt eval add15 m	111	62	$2K
76820		114	107	$2K
99217		28	28	$1K
90686		31	31	$412.65
99462		15	12	$404.70
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	34	34	$326.52

Medicaid Provider Spending