CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.

$6.73M

Total Medicaid Paid

68,964

Total Claims

66,011

Beneficiaries

43

Codes Billed

2018-01

First Month

2022-06

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic service	30,541	28,798	$6.70M
99212		7,243	7,092	$14K
G0467	Fqhc visit, estab pt	174	168	$5K
99213		7,063	6,783	$2K
G2025	Dis site tele svcs rhc/fqhc	65	64	$1K
99214		4,080	3,975	$707.00
90662		85	85	$64.79
83036		710	706	$16.90
82962		465	460	$3.96
36415		1,471	1,457	$2.70
G8510	Scr dep neg, no plan reqd	2,697	2,524	$0.25
S9452	Nutrition class	1,697	1,647	$0.00
3074F		359	354	$0.00
S9451	Exercise class	1,536	1,489	$0.00
3079F		180	179	$0.00
90471		307	307	$0.00
G9664	Taking statin or rec'd order	255	253	$0.00
3008F		1,935	1,881	$0.00
93000		480	476	$0.00
99000		704	695	$0.00
J7620	Albuterol ipratrop non-comp	12	12	$0.00
99202		14	14	$0.00
3075F		169	169	$0.00
1000F		87	85	$0.00
90688		241	241	$0.00
3044F		309	307	$0.00
1126F		76	75	$0.00
90686		79	79	$0.00
4010F		50	50	$0.00
G0008	Admin influenza virus vac	118	118	$0.00
96372		14	13	$0.00
1159F		3,754	3,508	$0.00
1158F		570	548	$0.00
82947		169	168	$0.00
81002		25	25	$0.00
3078F		643	632	$0.00
3077F		278	275	$0.00
3051F		29	28	$0.00
1160F		49	49	$0.00
G8431	Pos clin depres scrn f/u doc	178	169	$0.00
3046F		15	15	$0.00
99215	Prolong outpt/office vis	12	12	$0.00
99211		26	26	$0.00

Medicaid Provider Spending