SALEM HEALTH PROFESSIONAL SERVICES

$5.95M

Total Medicaid Paid

105,826

Total Claims

88,083

Beneficiaries

69

Codes Billed

2018-01

First Month

2021-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		35,344	33,114	$1.83M
99203		7,211	6,716	$726K
99232		16,617	6,954	$726K
J0585	Injection,onabotulinumtoxina	1,230	633	$615K
99213		12,967	12,109	$455K
99204		2,777	2,648	$358K
99239		3,069	2,725	$203K
99223	Prolong inpt eval add15 m	1,247	1,225	$160K
99233	Prolong inpt eval add15 m	1,762	997	$109K
76816		1,865	1,641	$105K
99460		874	843	$80K
64615		525	511	$72K
99202		876	839	$66K
99238		1,064	1,012	$58K
95811		487	471	$46K
99479		350	86	$44K
76811		310	298	$37K
87880		3,653	3,511	$34K
95810		220	213	$24K
99215	Prolong outpt/office vis	752	713	$19K
99231		1,016	302	$18K
99220		144	143	$17K
59025		335	157	$14K
99469		46	12	$12K
96372		653	579	$10K
99212		422	411	$10K
99222		94	94	$9K
99462		182	171	$8K
76813		93	89	$8K
99464		105	100	$8K
99221		105	89	$7K
99406		287	267	$6K
99219		84	79	$6K
90471		586	560	$5K
99391		44	31	$4K
90686		543	537	$4K
96160		912	846	$3K
95886		31	30	$3K
81003		2,332	2,211	$3K
87502		58	53	$3K
99442		382	336	$3K
87804		260	169	$3K
G0444	Depression screen annual	358	330	$2K
94760		822	788	$2K
90834		340	210	$2K
71046		85	81	$2K
99217		29	29	$2K
99443		93	81	$1K
81025		291	278	$1K
76815		16	15	$1K
95874		12	12	$556.98
96127		204	200	$554.84
36415		802	743	$486.71
98968		18	12	$429.34
99441		50	42	$387.12
90791		70	68	$360.60
94640		37	34	$335.32
93880		12	12	$297.63
87651		13	13	$295.68
J1885	Ketorolac tromethamine inj	238	224	$223.30
99421		20	20	$186.40
J1100	Dexamethasone sodium phos	229	222	$139.84
96161		50	31	$116.02
92551		29	27	$111.37
83036		16	14	$88.39
99173		13	13	$36.05
82962		15	13	$24.53
90688		17	16	$17.84
J7620	Albuterol ipratrop non-comp	33	30	$2.17

Medicaid Provider Spending