PROVIDENCE HEALTH & SERVICES MT

$5.67M

Total Medicaid Paid

86,982

Total Claims

67,754

Beneficiaries

58

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		23,429	20,928	$2.05M
99232		20,389	9,414	$1.15M
99213		13,910	12,712	$940K
90792		2,413	2,286	$352K
99239		2,496	2,343	$238K
99223	Prolong inpt eval add15 m	1,023	946	$140K
99233	Prolong inpt eval add15 m	1,794	850	$135K
99215	Prolong outpt/office vis	785	744	$101K
99231		1,750	973	$66K
99205	Prolong outpt/office vis	285	266	$45K
90832		1,030	570	$41K
99204		303	276	$40K
J0585	Injection,onabotulinumtoxina	220	118	$39K
90834		646	412	$35K
90471		1,264	1,215	$25K
36415		6,570	5,988	$23K
99203		225	219	$19K
99443		310	257	$19K
90837		233	131	$16K
99310	Prolong nursin fac eval 15m	844	771	$15K
99309		1,053	894	$15K
99441		353	349	$14K
99222		152	141	$14K
95811		83	79	$14K
95251		508	448	$13K
99442		232	210	$11K
64405		106	106	$9K
95810		69	69	$9K
99394		79	78	$9K
95886		74	61	$9K
83036		1,372	1,158	$8K
G0108	Diab manage trn per indiv	141	135	$8K
90686		716	696	$6K
64615		120	117	$5K
90791		53	51	$5K
94729		321	313	$4K
99238		70	64	$3K
94726		222	214	$3K
90833		65	57	$3K
99202		43	42	$3K
99212		70	67	$3K
95910		17	15	$3K
99308		273	215	$2K
99395		12	12	$2K
94060		166	156	$1K
99497		19	12	$802.53
87635		19	17	$759.39
G2212	Prolong outpt/office vis	16	13	$661.61
0124A		17	17	$520.00
87804		30	14	$505.80
90682		12	12	$392.07
99356		28	27	$296.51
J2920	Methylprednisolone injection	78	78	$244.20
94618		14	12	$149.46
90656		12	12	$127.36
G2012	Brief check in by md/qhp	14	14	$0.00
J3490	Drugs unclassified injection	100	95	$0.00
36416		334	265	$0.00

Medicaid Provider Spending