CRYSTAL LAKE CLINIC P.C.

$1.47M

Total Medicaid Paid

36,390

Total Claims

34,336

Beneficiaries

58

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		9,509	8,823	$748K
99213		8,250	7,690	$449K
99396		660	660	$63K
99395		464	462	$39K
99215	Prolong outpt/office vis	362	352	$39K
99393		326	326	$25K
99394		295	294	$24K
99392		301	301	$23K
99391		266	259	$17K
90471		1,610	1,595	$12K
90472		481	474	$7K
87880		350	346	$5K
99406		444	422	$3K
90686		529	529	$3K
92551		307	307	$2K
90460		99	97	$2K
90688		135	133	$2K
96372		159	149	$1K
87804		103	103	$1K
90756		51	51	$1K
99188		115	115	$830.23
81002		387	370	$817.95
96160		486	480	$787.05
D0190		39	39	$566.48
96127		199	198	$512.53
87426		19	19	$468.16
81003		270	253	$431.41
90674		13	13	$309.44
94760		419	374	$269.04
90670		220	214	$205.11
83036		12	12	$89.24
G8417	Calc bmi abv up param f/u	3,844	3,463	$23.96
G8427	Docrev cur meds by elig clin	869	848	$11.92
G9002	Mccd,maintenance rate	166	165	$0.42
2014F		295	295	$0.26
3074F		557	531	$0.25
3078F		478	459	$0.19
3079F		236	227	$0.16
S0257	End of life counseling	15	14	$0.15
G8420	Calc bmi norm parameters	1,224	1,118	$0.06
3077F		31	28	$0.05
3008F		488	459	$0.01
3075F		44	43	$0.01
G8476	Bp sys <140 and dias <90	329	322	$0.00
99173		312	312	$0.00
90633		56	56	$0.00
90648		25	25	$0.00
4004F		54	50	$0.00
90461		29	27	$0.00
90707		33	33	$0.00
90734		44	44	$0.00
90685		12	12	$0.00
90696		15	15	$0.00
G8418	Calc bmi blw low param f/u	113	100	$0.00
90716		35	35	$0.00
90651		26	26	$0.00
G8419	Calc bmi out nrm param nof/u	166	155	$0.00
90698		14	14	$0.00

Medicaid Provider Spending