HOLY FAMILY MEDICAL INC

$3.13M

Total Medicaid Paid

37,594

Total Claims

35,707

Beneficiaries

52

Codes Billed

2020-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		12,112	11,140	$1.69M
99213		3,286	3,147	$508K
99394		1,477	1,452	$253K
99393		1,432	1,407	$241K
99392		928	919	$170K
99391		467	440	$88K
99395		198	196	$38K
99203		179	175	$32K
99204		97	97	$19K
G0467	Fqhc visit, estab pt	1,039	787	$13K
90472		1,469	1,443	$11K
90471		2,531	2,494	$10K
99211		48	47	$10K
96110		544	534	$10K
99173		2,910	2,857	$9K
92552		2,975	2,919	$9K
99212		43	37	$8K
99396		13	13	$3K
0001A		49	47	$502.00
0002A		29	27	$440.00
91300		152	131	$213.02
90686		683	680	$164.79
87880		890	874	$90.00
81002		208	196	$6.78
G8427	Docrev cur meds by elig clin	429	409	$0.00
90734		381	373	$0.00
T1015	Clinic service	304	288	$0.00
3078F		314	308	$0.00
87804		192	95	$0.00
90671		28	28	$0.00
90715		54	52	$0.00
90670		162	158	$0.00
3725F		117	116	$0.00
G8417	Calc bmi abv up param f/u	26	24	$0.00
G8783	Bp scrn perf rec interval	13	13	$0.00
90700		27	27	$0.00
90633		46	45	$0.00
G9744	Pt not eli d/t act dig htn	14	13	$0.00
4551F		47	47	$0.00
G9903	Pt scrn tbco id as non user	395	382	$0.00
90620		186	183	$0.00
87428		482	477	$0.00
90651		234	230	$0.00
3074F		28	28	$0.00
3353F		100	100	$0.00
87426		15	15	$0.00
83036		27	27	$0.00
G9579	No doc opioid tx 1x at ther	13	12	$0.00
90647		56	53	$0.00
G8418	Calc bmi blw low param f/u	14	14	$0.00
1036F		14	14	$0.00
90656		117	117	$0.00

Medicaid Provider Spending