EMPIRE HEALTH SYSTEMS

$13K

Total Medicaid Paid

27,257

Total Claims

9,630

Beneficiaries

45

Codes Billed

2022-08

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		2,792	1,342	$3K
99489	Ccm add 20min	100	100	$2K
99487	Ccm add 20min	105	101	$2K
99213		401	212	$972.50
95957		41	36	$869.06
97032		2,654	777	$760.17
99457		126	122	$590.64
99458		120	117	$486.80
99454		102	95	$461.57
95004		13	13	$452.34
G2212	Prolong outpt/office vis	361	248	$376.20
99215	Prolong outpt/office vis	644	453	$304.76
95930		41	36	$268.83
95816		41	36	$234.49
99204		21	14	$134.33
92652		41	36	$99.29
97016		2,305	643	$98.72
96137		41	36	$43.79
96136		41	36	$30.26
97112		2,303	643	$27.20
96112		226	210	$20.92
93040		41	36	$8.41
96375		1,132	464	$5.31
96365		1,132	464	$2.27
96367		1,132	464	$0.34
96368		1,132	464	$0.02
96116		239	222	$0.00
99490	Ccm add 20min	160	155	$0.00
J3415	Pyridoxine hcl 100 mg	1,114	452	$0.00
93015		54	47	$0.00
99453		91	83	$0.00
G0444	Depression screen annual	27	24	$0.00
93970		36	29	$0.00
J3490	Drugs unclassified injection	6,501	464	$0.00
J3420	Vitamin b12 injection	1,122	453	$0.00
93000		89	79	$0.00
96132		41	36	$0.00
99406		71	64	$0.00
76700		24	12	$0.00
95115		375	98	$0.00
G0439	Ppps, subseq visit	18	17	$0.00
G0442	Annual alcohol screen 15 min	70	63	$0.00
95165		76	76	$0.00
99439		47	44	$0.00
99205	Prolong outpt/office vis	14	14	$0.00

Medicaid Provider Spending