ALII HEALTH CENTER

$806K

Total Medicaid Paid

49,351

Total Claims

42,492

Beneficiaries

72

Codes Billed

2019-10

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		4,762	3,999	$212K
99213		10,112	8,326	$197K
93306		411	356	$52K
99392		1,469	1,381	$41K
99391		1,309	1,211	$41K
99393		1,444	1,373	$38K
0002A		978	844	$33K
99203		625	581	$32K
S0302	Completed epsdt	783	705	$27K
99394		812	757	$20K
43239		187	164	$14K
99202		354	331	$13K
87635		287	273	$12K
45380		112	80	$12K
90460		4,163	3,921	$11K
99204		119	109	$11K
0001A		465	441	$10K
44361		118	95	$7K
93000		340	290	$4K
99212		128	106	$3K
0071A		66	62	$2K
0072A		63	62	$2K
90471		412	381	$2K
93351		12	12	$2K
99211		71	67	$870.17
99383		26	25	$847.53
99215	Prolong outpt/office vis	14	13	$790.60
90461		1,792	1,670	$740.68
99201		26	24	$659.69
90677		168	139	$586.94
87811		13	13	$432.14
87804		70	33	$394.46
96110		846	810	$340.20
96127		653	624	$297.16
90686		1,623	1,526	$119.83
90472		127	115	$80.63
G2211	Complex e/m visit add on	19	15	$80.21
81003		47	38	$58.99
90670		832	774	$8.02
90698		755	693	$4.03
90680		619	568	$4.02
90744		215	200	$4.01
3074F		1,831	1,428	$0.76
G8427	Docrev cur meds by elig clin	535	476	$0.60
3078F		1,549	1,183	$0.53
3079F		407	291	$0.28
3077F		335	185	$0.13
3075F		66	48	$0.05
1160F		612	540	$0.05
90656		231	226	$0.03
3080F		44	26	$0.02
G8420	Calc bmi norm parameters	272	186	$0.01
90651		224	209	$0.00
G9903	Pt scrn tbco id as non user	793	671	$0.00
G8510	Scr dep neg, no plan reqd	955	897	$0.00
90716		113	109	$0.00
G9273	Sys<140 and dia<90	344	313	$0.00
1111F		63	56	$0.00
91307		173	158	$0.00
90688		23	20	$0.00
90620		12	12	$0.00
1000F		16	12	$0.00
G8417	Calc bmi abv up param f/u	2,729	1,714	$0.00
90633		168	159	$0.00
G8783	Bp scrn perf rec interval	54	51	$0.00
90671		63	58	$0.00
90707		113	109	$0.00
90734		51	48	$0.00
90658		63	60	$0.00
91300		23	13	$0.00
0502F		30	15	$0.00
90715		12	12	$0.00

Medicaid Provider Spending