CLINICA MEDICA DEL SOL, LLC

$4.21M

Total Medicaid Paid

74,891

Total Claims

63,678

Beneficiaries

45

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		33,335	26,694	$2.05M
99213		16,388	13,409	$825K
99215	Prolong outpt/office vis	6,751	6,167	$472K
99396		2,591	2,551	$239K
99395		1,817	1,782	$160K
99385		1,322	1,295	$125K
99386		616	606	$67K
99203		913	889	$61K
99204		578	553	$53K
99394		397	395	$34K
96372		2,028	1,764	$26K
99393		218	217	$16K
99397		294	293	$15K
90471		800	787	$15K
90460		399	381	$10K
90756		505	475	$7K
90686		487	471	$6K
99212		173	159	$5K
99205	Prolong outpt/office vis	19	19	$3K
81002		906	815	$2K
90656		159	159	$2K
0012A		74	74	$2K
93000		124	119	$1K
0011A		106	104	$1K
87804		104	95	$1K
J2930	Methylprednisolone injection	226	208	$1K
87811		43	42	$977.25
99173		618	566	$858.63
36415		277	272	$798.05
G0439	Ppps, subseq visit	187	178	$689.40
99497		15	12	$671.95
90661		31	30	$575.41
Q0091	Obtaining screen pap smear	13	13	$503.06
90694		13	12	$389.39
J1885	Ketorolac tromethamine inj	255	222	$366.03
82962		122	104	$289.77
87880		23	21	$276.84
90653		13	13	$208.59
90662		27	25	$200.40
J0696	Ceftriaxone sodium injection	124	117	$176.62
G0008	Admin influenza virus vac	92	90	$26.22
1101F		1,642	1,416	$0.07
1111F		12	12	$0.00
91301		39	39	$0.00
90649		15	13	$0.00

Medicaid Provider Spending