OGDEN CLINIC SPECIALTY SERVICES LLC

$1.72M

Total Medicaid Paid

40,150

Total Claims

35,016

Beneficiaries

71

Codes Billed

2021-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		9,504	8,490	$584K
99213		7,362	6,582	$327K
99204		2,510	2,393	$216K
99203		2,833	2,693	$172K
43239		839	776	$138K
99215	Prolong outpt/office vis	485	398	$36K
88305		604	476	$34K
11102		422	398	$19K
17110		285	267	$15K
59025		830	636	$15K
96413		453	267	$14K
99205	Prolong outpt/office vis	92	86	$10K
45385		39	38	$10K
95117		1,435	527	$9K
80053		1,066	935	$7K
99212		241	227	$7K
95811		58	53	$6K
82728		499	479	$6K
69436		99	53	$6K
85025		1,457	1,221	$6K
92567		831	787	$5K
36415		2,255	2,048	$5K
80050		172	160	$5K
95810		45	43	$5K
95165		60	51	$5K
92557		163	157	$4K
82306		166	157	$4K
87428		54	54	$4K
96372		670	463	$3K
80400		95	81	$3K
83550		367	350	$3K
81025		394	366	$3K
73630		178	127	$3K
87086		325	303	$2K
83540		399	378	$2K
82607		181	173	$2K
J0702	Betamethasone acet&sod phosp	134	122	$2K
00731		13	13	$2K
90791		33	21	$1K
84443		116	106	$1K
99222		26	26	$1K
17000		59	54	$1K
94762		56	54	$949.62
99223	Prolong inpt eval add15 m	12	12	$927.12
96158		13	12	$862.31
81002		406	369	$791.64
80061		75	75	$692.20
84681		27	26	$684.77
G2211	Complex e/m visit add on	522	495	$675.97
84439		149	137	$602.09
83735		128	100	$565.38
83525		41	40	$562.27
82533		32	29	$560.81
92552		25	25	$560.38
J3301	Triamcinolone acet inj nos	203	186	$530.36
U0002	Covid-19 lab test non-cdc	13	12	$465.67
84481		30	30	$355.91
92556		12	12	$307.51
95115		53	26	$234.82
83036		27	27	$169.34
84550		41	41	$111.58
85651		14	14	$36.55
87880		16	16	$34.48
17003		12	12	$30.85
J1100	Dexamethasone sodium phos	134	77	$28.77
51798		12	12	$25.73
Q9966	Locm 200-299mg/ml iodine,1ml	25	24	$3.73
96375		77	39	$0.83
J2469	Palonosetron hcl	46	25	$0.00
96367		78	40	$0.00
G0500	Mod sedat endo service >5yrs	22	14	$0.00

Medicaid Provider Spending