MALTMAN MEDICAL CENTER LLC

$2.72M

Total Medicaid Paid

91,564

Total Claims

67,087

Beneficiaries

51

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
J2315	Naltrexone, depot form	1,932	1,299	$982K
99214		17,744	12,378	$812K
99204		2,896	2,347	$233K
99213		3,563	2,862	$117K
99395		1,602	1,318	$100K
96160		6,134	4,141	$59K
81025		10,326	7,264	$43K
99406		6,603	4,764	$41K
80305		7,237	5,094	$36K
G0444	Depression screen annual	4,333	3,470	$32K
93000		2,760	2,202	$31K
96372		2,823	1,799	$30K
99396		507	424	$30K
94010		1,533	1,240	$30K
99401		1,963	1,412	$27K
G0442	Annual alcohol screen 15 min	3,296	2,739	$17K
81002		7,492	5,594	$13K
87811		393	319	$13K
G0397	Alcohol/subs interv >30 min	417	302	$11K
99408		681	464	$11K
87636		72	66	$8K
G0101	Ca screen;pelvic/breast exam	320	260	$8K
36415		3,299	2,404	$5K
G0447	Behavior counsel obesity 15m	360	301	$4K
90460		100	78	$3K
90674		142	110	$3K
99393		31	29	$2K
3008F		720	577	$2K
87804		121	92	$2K
Q0091	Obtaining screen pap smear	60	41	$2K
99173		346	310	$2K
90471		206	149	$1K
99394		14	14	$1K
G0396	Alcohol/subs interv 15-30mn	63	40	$977.39
90686		151	131	$952.60
87635		22	18	$923.06
99212		38	27	$770.52
99326		21	14	$544.12
90688		38	32	$539.23
99211		44	36	$422.32
90685		36	26	$327.43
87880		32	27	$303.14
87210		94	82	$241.83
J2930	Methylprednisolone injection	178	118	$221.20
98960		13	12	$115.69
82948		49	43	$102.23
J1100	Dexamethasone sodium phos	178	118	$60.71
82962		13	12	$31.72
M1207	Pt scrn sdoh	494	428	$0.00
99000		52	42	$0.00
99072		22	18	$0.00

Medicaid Provider Spending