TIDALHEALTH PRIMARY CARE, LLC

$2.44M

Total Medicaid Paid

125,039

Total Claims

98,542

Beneficiaries

50

Codes Billed

2020-09

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		19,090	15,109	$1.13M
99214		11,717	9,694	$845K
G8510	Scr dep neg, no plan reqd	22,039	17,205	$109K
3074F		18,509	13,910	$71K
3078F		13,701	10,232	$48K
99391		319	225	$26K
99309		1,036	872	$24K
99204		218	175	$23K
3079F		5,956	4,559	$19K
99308		929	707	$15K
90686		1,088	836	$15K
99395		125	82	$12K
G8420	Calc bmi norm parameters	1,700	1,419	$12K
99203		110	81	$12K
G8427	Docrev cur meds by elig clin	12,299	9,983	$12K
99212		201	129	$10K
3044F		2,555	1,992	$9K
99215	Prolong outpt/office vis	65	39	$7K
90677		72	72	$5K
99442		134	114	$5K
90471		473	354	$4K
99396		45	24	$4K
3075F		1,445	1,106	$3K
99495		29	25	$3K
90750		12	12	$2K
90648		66	64	$2K
90723		63	62	$2K
96372		47	37	$1K
G8417	Calc bmi abv up param f/u	532	464	$1K
G8431	Pos clin depres scrn f/u doc	98	78	$1K
3077F		498	407	$1K
99381		18	13	$1K
G0008	Admin influenza virus vac	408	345	$829.82
90715		22	12	$731.49
99443		13	12	$643.19
3080F		214	181	$380.00
3051F		111	95	$329.75
90713		13	13	$321.02
G2211	Complex e/m visit add on	45	45	$168.33
3052F		22	14	$83.40
3046F		19	13	$58.61
90694		60	53	$30.50
G9664	Taking statin or rec'd order	1,490	1,310	$28.86
90656		13	12	$19.89
90662		80	58	$10.37
1101F		3,243	2,790	$0.00
1111F		17	13	$0.00
3288F		3,764	3,191	$0.00
90461		132	129	$0.00
90460		184	175	$0.00

Medicaid Provider Spending