SURE, HERTZEL

$771K

Total Medicaid Paid

41,802

Total Claims

32,930

Beneficiaries

59

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		8,071	5,845	$413K
99213		2,039	1,625	$111K
99442		904	742	$43K
99396		503	444	$40K
99203		393	388	$27K
93000		2,329	2,214	$27K
99395		276	251	$20K
99205	Prolong outpt/office vis	78	76	$10K
81002		6,331	4,795	$9K
81025		1,607	1,264	$8K
96372		771	521	$7K
87426		287	259	$7K
90471		288	277	$4K
93922		211	188	$4K
99215	Prolong outpt/office vis	39	38	$4K
82948		2,197	1,534	$4K
90756		182	180	$4K
99204		29	28	$3K
99308		61	28	$3K
87811		105	96	$2K
71045		127	116	$2K
82962		2,119	1,465	$2K
87635		49	46	$2K
99211		121	110	$2K
99441		190	151	$2K
76700		13	13	$1K
0013A		30	30	$1K
36415		3,188	2,974	$1K
95923		29	27	$1K
82947		437	304	$921.21
G0447	Behavior counsel obesity 15m	69	58	$876.46
0011A		26	25	$696.47
94010		30	28	$687.14
0012A		24	24	$655.38
87070		115	107	$650.30
95921		28	27	$572.41
82607		80	53	$421.58
G0270	Mnt subs tx for change dx	156	130	$412.46
G0444	Depression screen annual	43	37	$403.72
90688		26	26	$269.57
J3420	Vitamin b12 injection	244	137	$244.53
94640		18	12	$179.67
G0439	Ppps, subseq visit	32	15	$127.27
89220		31	31	$98.47
94760		93	88	$37.46
1160F		1,174	916	$34.02
3078F		367	297	$10.08
3074F		314	265	$10.07
3075F		58	52	$2.53
J7613	Albuterol non-comp unit	18	12	$0.57
3008F		3,152	2,220	$0.46
1159F		900	684	$0.01
3079F		56	50	$0.01
3725F		198	195	$0.00
4035F		456	439	$0.00
G8417	Calc bmi abv up param f/u	30	27	$0.00
3077F		55	50	$0.00
1030F		643	599	$0.00
99429		362	297	$0.00

Medicaid Provider Spending