KODIAK ISLAND AMBULATORY CARE CLINIC INC.

$2.59M

Total Medicaid Paid

36,931

Total Claims

21,941

Beneficiaries

29

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		13,839	6,923	$1.63M
99213		5,842	4,104	$532K
99215	Prolong outpt/office vis	1,080	745	$160K
87635		2,546	1,961	$107K
87804		4,942	2,022	$67K
87807		1,902	1,536	$21K
M0222	Bebtelovimab injection	55	48	$19K
99204		47	45	$9K
0001A		172	161	$7K
0002A		165	142	$6K
87880		425	329	$5K
81001		1,849	1,171	$4K
99203		27	26	$4K
92567		125	97	$3K
0003A		50	46	$2K
90460		76	64	$2K
J3301	Triamcinolone acet inj nos	464	281	$2K
99490	Ccm add 20min	155	155	$2K
99212		35	29	$2K
96365		22	18	$1K
J0696	Ceftriaxone sodium injection	451	300	$1K
J1885	Ketorolac tromethamine inj	735	338	$871.86
36415		661	418	$660.75
82962		156	97	$269.89
85018		69	42	$118.58
G2023	Specimen collect covid-19	928	747	$46.92
J7030	Normal saline solution infus	37	32	$19.30
85651		17	13	$4.27
Q0222	Bebtelovimab 175 mg	59	51	$0.00

Medicaid Provider Spending