1215131065

$655K

Total Medicaid Paid

73,268

Total Claims

66,503

Beneficiaries

72

Codes Billed

2018-01

First Month

2023-07

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		9,011	7,916	$243K
99214		3,650	3,023	$89K
99393		940	914	$72K
99394		799	788	$62K
99392		595	589	$47K
99212		1,178	1,104	$35K
90460		3,281	3,195	$21K
99396		297	272	$18K
99391		211	203	$17K
97802		2,023	1,988	$16K
99395		173	147	$9K
99441		731	702	$7K
99203		58	56	$4K
93000		1,584	1,321	$4K
99385		67	57	$2K
99442		93	85	$1K
99382		12	12	$1K
99204		13	12	$999.09
87811		61	56	$841.97
90686		1,471	1,423	$817.46
83036		254	205	$589.94
99211		39	39	$553.61
87804		144	140	$511.05
36415		188	179	$460.00
90461		998	955	$132.61
81003		192	170	$105.82
99490	Ccm add 20min	90	73	$94.35
1126F		5,466	4,926	$88.31
3074F		4,578	4,156	$50.46
3288F		1,287	1,142	$50.44
90651		338	330	$50.00
87880		14	13	$39.68
90620		114	107	$30.00
3075F		1,259	1,150	$25.22
3077F		920	831	$25.22
G0444	Depression screen annual	1,644	1,455	$23.47
36416		33	28	$12.61
1159F		5,094	4,568	$12.61
90670		254	249	$10.04
92567		2,074	2,026	$8.18
S9452	Nutrition class	60	59	$0.25
1160F		6,537	5,834	$0.01
3078F		4,724	4,253	$0.01
3079F		1,852	1,701	$0.00
1101F		1,081	988	$0.00
3044F		226	197	$0.00
90723		38	38	$0.00
1125F		721	671	$0.00
S9451	Exercise class	1,747	1,630	$0.00
96127		293	278	$0.00
3080F		130	108	$0.00
1170F		837	720	$0.00
1036F		37	25	$0.00
90716		15	15	$0.00
G0439	Ppps, subseq visit	27	24	$0.00
G8950	Pre-htn or htn doc, f/u indc	133	113	$0.00
3008F		198	154	$0.00
G0008	Admin influenza virus vac	45	31	$0.00
99173		1,906	1,753	$0.00
3725F		107	102	$0.00
90648		148	146	$0.00
G2012	Brief check in by md/qhp	16	15	$0.00
1158F		401	356	$0.00
90715		12	12	$0.00
G8427	Docrev cur meds by elig clin	227	186	$0.00
90707		40	40	$0.00
90685		76	76	$0.00
90734		164	160	$0.00
G8731	Pain neg no plan	161	135	$0.00
90713		12	12	$0.00
90633		55	54	$0.00
G8783	Bp scrn perf rec interval	14	12	$0.00

Medicaid Provider Spending