NORTHERN HOSPITAL OF SURRY COUNTY

$1.53M

Total Medicaid Paid

115,801

Total Claims

94,679

Beneficiaries

44

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		21,769	17,357	$928K
99213		10,700	9,088	$351K
99199		31,097	26,090	$207K
99215	Prolong outpt/office vis	660	534	$29K
96127		963	678	$3K
99407		282	213	$2K
87804		277	112	$2K
87426		59	45	$1K
99406		106	84	$737.99
99499		2,008	1,289	$575.00
99051		36	35	$553.01
1159F		6,742	5,400	$433.66
3008F		5,152	4,209	$408.55
1160F		3,834	3,201	$356.42
90471		55	28	$300.16
1036F		3,549	2,877	$292.87
96372		61	54	$281.77
1126F		3,023	2,578	$278.15
1125F		5,645	4,581	$258.26
90686		50	38	$229.16
0513F		1,957	1,552	$202.68
87880		14	13	$130.57
99490	Ccm add 20min	14	13	$128.40
3078F		2,667	2,164	$100.30
3074F		2,653	2,131	$100.18
3075F		242	213	$75.03
4004F		1,766	1,407	$50.15
1124F		3,821	3,184	$50.15
J0725	Chorionic gonadotropin/1000u	36	33	$43.41
3079F		646	531	$25.03
3044F		600	516	$10.02
G8482	Flu immunize order/admin	1,274	1,070	$0.79
G8864	Pneumococcal vaccine admin	1,016	843	$0.35
G8866	Doc pt reas no pneumococcal	392	312	$0.11
G8483	Flu imm no admin doc rea	1,120	934	$0.09
3048F		221	179	$0.02
G8451	Pt w/abn lvef inelig b-bloc	275	234	$0.01
G8510	Scr dep neg, no plan reqd	14	14	$0.00
G0439	Ppps, subseq visit	14	14	$0.00
1123F		137	105	$0.00
G9273	Sys<140 and dia<90	68	59	$0.00
1170F		13	13	$0.00
3725F		742	628	$0.00
3077F		31	26	$0.00

Medicaid Provider Spending