DESERT VALLEY MEDICAL GROUP, INC.

$755K

Total Medicaid Paid

33,413

Total Claims

31,482

Beneficiaries

55

Codes Billed

2018-05

First Month

2021-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
S9083	Urgent care center global	10,589	9,888	$581K
99214		2,860	2,717	$31K
99284		346	342	$22K
93306		647	643	$21K
93010		1,930	1,733	$20K
99203		506	495	$15K
99223	Prolong inpt eval add15 m	243	239	$14K
99213		3,148	2,909	$13K
93000		294	292	$6K
99381		190	190	$5K
99283		94	93	$4K
99233	Prolong inpt eval add15 m	250	104	$4K
87635		1,440	1,285	$4K
99204		117	117	$3K
99202		92	91	$3K
92551		211	209	$2K
99391		380	379	$1K
99239		60	56	$1K
87811		310	298	$993.12
99383		199	199	$651.36
99384		117	115	$455.84
99282		15	15	$362.10
96110		678	676	$285.12
99392		708	708	$259.14
99232		45	16	$187.10
99394		144	144	$162.84
88720		32	32	$131.10
99442		34	28	$121.98
99382		87	87	$93.32
99188		511	507	$89.10
96372		729	679	$78.74
99222		25	25	$72.47
99393		234	234	$43.41
96127		62	60	$23.80
J1885	Ketorolac tromethamine inj	460	448	$10.94
94760		2,290	2,162	$0.00
3080F		50	49	$0.00
3079F		151	151	$0.00
3075F		88	87	$0.00
94640		45	45	$0.00
J7620	Albuterol ipratrop non-comp	16	16	$0.00
3074F		282	275	$0.00
99070		21	21	$0.00
A6222	Gauze <=16 in no w/sal w/o b	12	12	$0.00
1111F		19	19	$0.00
81002		1,516	1,472	$0.00
3078F		310	302	$0.00
81025		154	150	$0.00
99396		15	15	$0.00
G9920	Scrning perf and negative	329	328	$0.00
J8499	Oral prescrip drug non chemo	26	25	$0.00
3077F		140	138	$0.00
87804		103	103	$0.00
99395		14	14	$0.00
87880		45	45	$0.00

Medicaid Provider Spending