MY CHOICE OPERATING COMPANY LLC

$457K

Total Medicaid Paid

60,102

Total Claims

37,988

Beneficiaries

44

Codes Billed

2021-04

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99349		20,269	13,443	$289K
99336		7,015	4,247	$103K
99348		3,203	2,245	$47K
99335		753	519	$13K
20553		819	423	$752.79
84443		232	142	$621.38
J7329	Inj, trivisc 1 mg	27	12	$500.60
80053		517	322	$467.55
20610		707	330	$395.72
82306		120	66	$221.96
99443		227	151	$205.47
85025		653	411	$200.41
36415		674	435	$172.02
80061		336	221	$155.29
P9604	One-way allow prorated trip	135	74	$124.53
G0179	Md recertification hha pt	632	441	$97.56
64451		20	13	$71.00
99344		13	12	$67.55
G0180	Md certification hha patient	239	154	$62.88
99442		91	68	$52.07
J1100	Dexamethasone sodium phos	1,178	594	$34.83
83036		134	76	$24.48
82607		88	53	$8.78
90792		20	14	$6.99
20550		80	35	$4.96
G8754	Dias bp less 90	3,256	1,725	$0.00
3044F		314	220	$0.00
1123F		3,181	2,091	$0.00
1036F		3,009	1,852	$0.00
G8755	Dias bp > or = 90	77	38	$0.00
82746		51	29	$0.00
G8734	Doc neg eld req	15	12	$0.00
64450		48	26	$0.00
G9922	Sfty cncrns scrn nd mit recs	15	12	$0.00
3288F		3,790	2,445	$0.00
G8427	Docrev cur meds by elig clin	4,756	3,120	$0.00
G8752	Sys bp less 140	2,578	1,353	$0.00
G9916	Funct status past 12 months	15	12	$0.00
G8753	Sys bp > or = 140	342	191	$0.00
1124F		358	264	$0.00
4004F		70	61	$0.00
0518F		15	12	$0.00
1100F		15	12	$0.00
3725F		15	12	$0.00

Medicaid Provider Spending