SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC

$4.06M

Total Medicaid Paid

108,228

Total Claims

90,950

Beneficiaries

61

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		33,618	28,172	$1.75M
99213		40,339	33,635	$1.40M
62323		1,911	1,734	$230K
G0481	Drug test def 8-14 classes	2,463	2,291	$184K
64635		434	350	$98K
99204		1,162	1,096	$96K
62321		331	323	$46K
64636		428	326	$44K
64493		267	251	$31K
27096		292	262	$25K
64494		414	223	$22K
80305		5,300	4,631	$11K
99152		579	473	$11K
76881		259	108	$10K
76882		701	285	$9K
J3301	Triamcinolone acet inj nos	10,086	8,244	$8K
77002		315	287	$7K
20553		229	218	$7K
G2211	Complex e/m visit add on	5,962	5,291	$7K
99215	Prolong outpt/office vis	66	63	$6K
99203		102	102	$6K
20610		189	176	$6K
G0482	Drug test def 15-21 classes	63	59	$5K
76942		123	115	$4K
20611		80	76	$3K
99212		81	76	$2K
97530		42	12	$2K
64483		13	12	$2K
99205	Prolong outpt/office vis	15	15	$2K
80371		45	40	$1K
80368		45	40	$1K
80353		45	40	$1K
80367		45	40	$1K
80358		45	40	$1K
80359		45	40	$1K
80354		45	40	$1K
80348		45	40	$1K
80366		45	40	$1K
80370		45	40	$1K
80361		45	40	$1K
80373		45	40	$1K
80360		45	40	$1K
80372		45	40	$1K
80365		45	40	$1K
80325		45	40	$1K
80346		45	40	$1K
80355		45	40	$1K
80053		38	37	$889.90
83992		45	40	$870.80
96372		129	117	$703.64
G0483	Drug test def 22+ classes	14	13	$336.87
98980		17	16	$291.12
J3010	Fentanyl citrate injection	503	409	$267.93
36415		81	78	$248.87
J2250	Inj midazolam hydrochloride	580	473	$133.27
90833		15	13	$53.78
J1885	Ketorolac tromethamine inj	25	24	$46.60
J1100	Dexamethasone sodium phos	12	12	$8.06
85025		39	38	$6.21
98977		18	17	$0.00
85652		38	37	$0.00

Medicaid Provider Spending