SACRED HEART HEALTH SYSTEM, INC.

$869K

Total Medicaid Paid

21,627

Total Claims

13,916

Beneficiaries

59

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1017	Targeted case management	7,693	3,801	$180K
99223	Prolong inpt eval add15 m	1,359	1,016	$165K
99233	Prolong inpt eval add15 m	2,050	815	$116K
99213		1,435	1,291	$56K
99238		1,283	978	$46K
99232		986	401	$35K
99239		488	378	$32K
H1000	Prenatal care atrisk assessm	772	543	$27K
99460		365	320	$23K
76816		393	328	$21K
99222		280	180	$17K
99236	Prolong inpt eval add15 m	202	135	$17K
99214		266	239	$17K
T1024	Team evaluation & management	170	152	$17K
76819		636	469	$15K
99215	Prolong outpt/office vis	111	104	$12K
99391		119	111	$11K
76811		78	77	$10K
99235		70	66	$9K
99392		60	60	$6K
92004		89	84	$5K
93306		25	25	$4K
93303		24	24	$4K
99243		72	49	$3K
99203		40	39	$3K
99462		166	118	$2K
91300		110	108	$2K
0002A		47	47	$2K
92014		43	37	$2K
0012A		49	49	$2K
93325		121	111	$1K
99244		20	14	$1K
92012		24	24	$734.58
94664		14	12	$533.87
90460		171	163	$416.00
99211		28	28	$359.64
92567		245	188	$321.35
92060		61	57	$295.25
93010		27	27	$199.23
76817		25	24	$139.17
3008F		83	67	$124.12
92587		36	26	$85.23
76820		142	74	$73.34
93000		77	74	$69.93
92015		270	240	$68.15
0001A		33	33	$46.00
1159F		133	115	$0.00
1160F		245	222	$0.00
90670		39	39	$0.00
3078F		13	13	$0.00
73630		13	12	$0.00
1036F		60	57	$0.00
87635		45	41	$0.00
91301		83	82	$0.00
3074F		14	14	$0.00
90647		13	13	$0.00
99024		74	65	$0.00
93320		24	24	$0.00
90723		13	13	$0.00

Medicaid Provider Spending