DOVE PEDIATRIC SERVICE

$1.84M

Total Medicaid Paid

99,643

Total Claims

97,235

Beneficiaries

69

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		13,791	12,724	$767K
90460		6,767	6,683	$201K
99393		2,270	2,259	$145K
99394		1,790	1,785	$125K
99392		1,889	1,845	$123K
92587		7,098	7,050	$106K
99391		1,139	1,050	$70K
90461		1,653	1,644	$52K
G0270	Mnt subs tx for change dx	7,442	7,231	$42K
96110		7,201	6,964	$34K
G0445	High inten beh couns std 30m	2,170	2,164	$24K
G0396	Alcohol/subs interv 15-30mn	1,778	1,775	$22K
G0447	Behavior counsel obesity 15m	2,726	2,647	$20K
94664		1,290	1,264	$16K
G0444	Depression screen annual	2,503	2,495	$12K
96127		5,530	5,497	$10K
G0442	Annual alcohol screen 15 min	2,418	2,407	$9K
90677		38	38	$8K
99395		123	121	$8K
99401		308	298	$6K
97803		5,750	5,621	$6K
36415		5,040	4,996	$5K
87110		625	620	$4K
99173		4,381	4,365	$4K
36406		843	822	$3K
G8510	Scr dep neg, no plan reqd	1,473	1,464	$3K
90651		310	310	$3K
92012		95	95	$1K
99429		264	255	$1K
87880		231	226	$1K
87426		75	74	$1K
99383		12	12	$1K
90619		83	83	$879.85
99203		12	12	$742.62
0072A		16	16	$625.76
96160		257	248	$601.98
0071A		15	15	$586.32
G0439	Ppps, subseq visit	13	13	$540.00
90686		1,054	1,050	$402.85
91307		64	53	$365.40
90688		68	68	$264.57
90471		13	13	$220.89
90670		219	217	$71.40
99493		17	17	$63.00
90656		92	92	$44.70
90660		34	34	$41.79
90633		112	112	$34.34
94760		195	190	$32.30
97802		136	135	$26.44
81000		12	12	$22.11
36410		25	25	$20.44
90716		29	29	$17.85
83655		12	12	$12.10
91300		16	15	$3.60
1031F		3,959	3,831	$0.00
4293F		1,406	1,397	$0.00
1036F		987	981	$0.00
90698		134	132	$0.00
90680		12	12	$0.00
90744		12	12	$0.00
99000		74	74	$0.00
96161		24	24	$0.00
1000F		65	65	$0.00
3725F		1,244	1,237	$0.00
90672		102	102	$0.00
90734		25	25	$0.00
1160F		26	25	$0.00
1032F		40	40	$0.00
90707		16	16	$0.00

Medicaid Provider Spending