COMMUNITY MEDICAL CENTER

$487K

Total Medicaid Paid

14,493

Total Claims

13,170

Beneficiaries

62

Codes Billed

2021-09

First Month

2024-05

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
95886		1,374	1,347	$68K
76816		1,395	1,310	$64K
76811		531	509	$58K
95165		63	38	$29K
95117		1,372	840	$29K
95004		511	500	$28K
87481		356	337	$24K
87661		609	577	$23K
87491		771	747	$19K
87591		658	635	$15K
X0621		72	52	$14K
95911		155	152	$11K
95910		110	110	$10K
17110		217	209	$9K
Q3014	Telehealth facility fee	523	495	$8K
92567		593	575	$7K
88175		255	247	$7K
87624		188	183	$7K
96900		405	94	$6K
11102		164	145	$5K
95885		131	129	$5K
92557		145	142	$4K
84443		195	192	$4K
86003		25	24	$4K
96372		212	206	$3K
64615		31	27	$3K
81025		622	603	$3K
87150		54	54	$2K
87086		247	244	$2K
94010		86	83	$2K
95909		16	16	$2K
83036		254	246	$1K
88305		156	127	$1K
76830		26	26	$1K
84439		151	150	$1K
76819		17	13	$1K
80053		83	80	$901.72
95908		12	12	$806.34
31231		12	12	$764.74
31575		12	12	$670.87
91200		34	34	$574.92
90471		56	56	$554.59
X0592		12	12	$467.60
82784		27	26	$297.80
82105		14	14	$265.54
69210		15	12	$255.83
G0008	Admin influenza virus vac	25	25	$231.71
87511		12	12	$231.23
36415		135	135	$204.15
80061		13	12	$191.17
85025		30	29	$182.07
17000		13	13	$171.35
85610		28	28	$97.57
86140		12	12	$34.08
90686		227	227	$0.00
G0463	Hospital outpt clinic visit	29	29	$0.00
J7298	Mirena, 52 mg	14	14	$0.00
90715		174	173	$0.00
J0585	Injection,onabotulinumtoxina	72	66	$0.00
J1050	Medroxyprogesterone acetate	590	589	$0.00
J3301	Triamcinolone acet inj nos	122	122	$0.00
J0665	Inj, bupivacaine, nos, 0.5mg	30	30	$0.00

Medicaid Provider Spending