PCC COMMUNITY WELLNESS CENTER

$818K

Total Medicaid Paid

35,954

Total Claims

20,017

Beneficiaries

49

Codes Billed

2018-05

First Month

2024-01

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic service	8,557	4,423	$802K
0124A		167	159	$7K
J1050	Medroxyprogesterone acetate	220	118	$4K
90686		488	396	$2K
96372		743	403	$2K
0012A		13	13	$547.82
81025		1,066	646	$445.09
90480		27	27	$413.25
90715		63	38	$272.91
0011A		13	13	$220.22
90670		202	132	$57.60
90651		68	53	$51.20
90744		51	36	$38.40
90633		68	53	$19.20
96110		964	667	$16.07
90696		18	12	$12.80
90710		18	12	$12.80
90734		49	29	$6.40
90700		32	12	$6.40
83036		98	53	$6.30
82962		377	138	$1.68
3008F		3,607	2,170	$0.00
90471		1,793	1,305	$0.00
2015F		458	266	$0.00
96127		2,953	1,241	$0.00
99213		3,022	1,705	$0.00
G8510	Scr dep neg, no plan reqd	1,651	922	$0.00
90698		47	29	$0.00
94200		366	191	$0.00
G8420	Calc bmi norm parameters	1,070	734	$0.00
S5190	Wellness assessment by nonph	179	151	$0.00
36416		637	194	$0.00
3074F		114	42	$0.00
99214		50	24	$0.00
3079F		34	14	$0.00
G8417	Calc bmi abv up param f/u	1,919	1,068	$0.00
99393		517	359	$0.00
90472		882	628	$0.00
H0050	Alcohol/drug service 15 min	792	247	$0.00
99391		194	129	$0.00
90832		315	129	$0.00
99392		466	319	$0.00
0502F		172	55	$0.00
99394		360	247	$0.00
G8431	Pos clin depres scrn f/u doc	383	171	$0.00
81002		442	165	$0.00
99212		145	53	$0.00
90756		46	13	$0.00
90791		38	13	$0.00

Medicaid Provider Spending