JOHN C FREMONT HEALTHCARE DISTRICT

$925K

Total Medicaid Paid

50,914

Total Claims

46,424

Beneficiaries

71

Codes Billed

2018-01

First Month

2023-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
0450		4,609	4,276	$234K
99199		2,140	2,071	$106K
99284		825	768	$80K
80053		5,482	5,112	$77K
84443		2,492	2,466	$52K
85025		4,736	4,441	$43K
T1999	Noc retail items andsupplies	1,819	909	$43K
82306		1,408	1,405	$34K
80061		2,331	2,325	$31K
83036		1,957	1,950	$23K
93306		75	75	$18K
0250		1,436	980	$17K
93005		677	627	$15K
84439		1,149	1,137	$13K
77067		120	120	$11K
96372		414	375	$10K
99283		132	130	$8K
96374		189	178	$8K
71046		428	410	$8K
83735		919	862	$7K
81001		1,290	1,216	$5K
96375		154	139	$5K
0270		1,251	868	$4K
0202U		215	211	$4K
J7030	Normal saline solution infus	566	457	$4K
96361		146	142	$4K
83690		250	237	$4K
87086		634	599	$4K
96365		76	70	$4K
87430		242	236	$3K
82607		508	505	$3K
74177		17	17	$3K
87804		305	295	$3K
87811		76	75	$3K
81002		919	894	$3K
84484		209	178	$2K
80048		212	195	$2K
77063		43	43	$2K
87070		194	185	$2K
70450		16	16	$2K
83605		138	116	$2K
99282		46	43	$2K
85610		381	315	$1K
71045		93	89	$1K
80307		25	25	$1K
81003		438	420	$1K
36415		5,015	4,611	$1K
82043		113	110	$835.11
85027		118	114	$830.61
0272		449	334	$683.51
94640		34	29	$662.65
85651		177	173	$651.28
J1885	Ketorolac tromethamine inj	121	116	$640.13
81025		100	96	$545.42
83880		16	13	$432.47
99001		1,571	1,488	$428.40
82550		53	43	$416.78
85730		56	53	$406.81
J2405	Ondansetron hcl injection	81	68	$404.39
J3490	Drugs unclassified injection	528	322	$399.09
86140		58	53	$349.81
0271		173	168	$319.54
87077		69	62	$270.88
87186		39	37	$208.66
85007		58	55	$179.54
83550		20	20	$160.08
J0696	Ceftriaxone sodium injection	26	24	$136.87
0258		48	33	$130.50
82150		14	14	$110.56
80377		168	161	$66.60
0259		27	24	$20.50

Medicaid Provider Spending