PRISMA HEALTH-UPSTATE

$8.32M

Total Medicaid Paid

73,396

Total Claims

43,829

Beneficiaries

51

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
96365		3,745	1,974	$3.80M
36415		11,917	6,714	$1.72M
96372		2,819	1,969	$1.29M
77336		1,618	666	$487K
99212		8,631	5,819	$237K
77300		234	189	$171K
96374		683	387	$108K
99211		3,419	2,638	$106K
99213		2,745	2,426	$91K
96375		2,396	1,265	$71K
96361		360	217	$47K
96413		1,932	1,097	$39K
80048		7,520	4,091	$36K
80053		720	466	$21K
77386		618	49	$14K
96367		66	44	$14K
85007		603	291	$14K
96366		899	457	$13K
36430		107	69	$11K
77334		284	181	$10K
99214		205	187	$9K
80076		4,741	3,140	$3K
86850		401	270	$3K
77412		176	25	$3K
85025		9,370	5,159	$982.65
G0463	Hospital outpt clinic visit	39	29	$865.42
83735		1,856	936	$779.05
P9016	Rbc leukocytes reduced	19	12	$585.80
97140		35	12	$394.16
86304		99	79	$241.12
83615		182	106	$155.08
T1015	Clinic service	22	17	$133.54
J1100	Dexamethasone sodium phos	544	238	$27.23
86901		401	270	$0.00
96415		119	69	$0.00
85027		664	323	$0.00
82728		138	129	$0.00
J2469	Palonosetron hcl	136	74	$0.00
84443		130	101	$0.00
J1200	Diphenhydramine hcl injectio	313	148	$0.00
J7040	Normal saline solution infus	1,469	759	$0.00
84466		147	139	$0.00
84439		55	38	$0.00
83540		147	139	$0.00
86900		402	270	$0.00
96417		42	28	$0.00
J1453	Fosaprepitant injection	38	26	$0.00
J0897	Denosumab injection	17	16	$0.00
86923		54	37	$0.00
J7030	Normal saline solution infus	102	31	$0.00
84100		17	13	$0.00

Medicaid Provider Spending