SAN LUIS WALK-IN CLINIC, INC.

$17.79M

Total Medicaid Paid

269,129

Total Claims

220,879

Beneficiaries

42

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic service	76,114	64,870	$16.81M
99212		64,820	49,737	$853K
99202		5,448	4,719	$116K
99213		10,152	8,467	$5K
96372		15,494	12,718	$4K
99211		584	431	$3K
93000		871	683	$924.43
J1885	Ketorolac tromethamine inj	5,826	4,836	$564.39
81000		14,761	11,850	$520.28
3008F		21,126	17,214	$262.53
3080F		1,414	1,284	$262.53
J0690	Cefazolin sodium injection	1,623	1,508	$168.81
81025		3,540	3,132	$162.43
J2550	Promethazine hcl injection	1,036	873	$104.67
94664		91	82	$93.22
J1030	Methylprednisolone 40 mg inj	553	476	$85.21
J1100	Dexamethasone sodium phos	2,154	1,766	$34.58
85018		586	504	$5.35
J0696	Ceftriaxone sodium injection	4,587	3,928	$5.30
82962		998	792	$4.05
3079F		4,289	3,815	$0.00
3075F		2,498	2,185	$0.00
87426		1,131	1,108	$0.00
3074F		9,893	8,420	$0.00
99214		205	203	$0.00
90471		60	60	$0.00
86580		20	12	$0.00
90656		17	17	$0.00
U0002	Covid-19 lab test non-cdc	21	21	$0.00
99441		172	165	$0.00
94640		25	15	$0.00
3078F		8,951	7,591	$0.00
3077F		1,166	921	$0.00
87880		3,463	2,668	$0.00
87804		3,379	2,535	$0.00
G2023	Specimen collect covid-19	272	268	$0.00
1159F		751	384	$0.00
J2930	Methylprednisolone injection	183	154	$0.00
99203		70	47	$0.00
99442		26	25	$0.00
1160F		739	377	$0.00
69209		20	18	$0.00

Medicaid Provider Spending