UPPER VALLEY PROFESSIONAL CORPORATION

$3.04M

Total Medicaid Paid

89,193

Total Claims

76,152

Beneficiaries

48

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		27,952	25,051	$1.13M
99214		13,054	11,591	$699K
90460		15,380	10,000	$409K
99391		6,371	5,717	$337K
99392		4,407	4,019	$264K
99393		500	477	$28K
96110		3,276	2,952	$26K
99460		238	218	$20K
96127		3,845	3,612	$15K
99223	Prolong inpt eval add15 m	333	305	$14K
87880		1,147	1,012	$13K
99215	Prolong outpt/office vis	151	126	$10K
90471		494	480	$9K
99204		104	92	$8K
99238		208	182	$7K
99212		352	301	$6K
99233	Prolong inpt eval add15 m	364	134	$6K
99222		142	112	$6K
99232		293	116	$5K
99394		58	54	$4K
99188		177	149	$4K
99239		153	132	$4K
90698		2,697	2,431	$3K
96161		1,284	1,144	$3K
90670		2,066	1,898	$2K
99202		54	49	$2K
87804		93	68	$2K
99203		28	26	$2K
D1206		81	81	$1K
99220		39	38	$1K
90686		2,002	1,902	$932.20
90680		742	672	$650.00
90633		66	60	$559.96
94640		39	38	$432.23
99219		14	13	$424.01
92551		66	64	$411.51
96372		12	12	$139.84
80305		20	17	$138.25
87807		12	12	$120.84
90744		158	136	$60.00
90656		177	171	$23.09
J7613	Albuterol non-comp unit	27	26	$4.27
G8427	Docrev cur meds by elig clin	117	109	$0.00
G8417	Calc bmi abv up param f/u	14	13	$0.00
90677		307	265	$0.00
G8419	Calc bmi out nrm param nof/u	39	37	$0.00
1036F		26	25	$0.00
G9903	Pt scrn tbco id as non user	14	13	$0.00

Medicaid Provider Spending