EDWARD W. SPARROW HOSPITAL ASSOCIATION

$616K

Total Medicaid Paid

37,413

Total Claims

35,254

Beneficiaries

43

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		5,677	5,363	$241K
99214		3,598	3,432	$222K
99392		576	576	$45K
99391		695	676	$41K
99393		274	274	$18K
99395		162	161	$11K
99204		79	79	$7K
99396		90	90	$7K
90471		884	876	$6K
90472		358	355	$5K
99394		45	45	$3K
90686		271	270	$3K
90460		177	176	$3K
99421		116	110	$1K
90632		14	14	$723.24
90670		54	53	$635.77
96127		174	169	$602.08
99212		13	13	$289.14
90688		14	14	$249.76
87880		14	14	$191.66
G2211	Complex e/m visit add on	675	629	$166.44
G8427	Docrev cur meds by elig clin	4,649	4,306	$0.00
G8484	Flu immunize no admin	2,395	2,222	$0.00
4004F		922	825	$0.00
G8482	Flu immunize order/admin	1,089	994	$0.00
G8752	Sys bp less 140	723	675	$0.00
G8417	Calc bmi abv up param f/u	1,139	1,039	$0.00
3078F		2,625	2,515	$0.00
G9899	Scrn mam perf rslts doc	258	243	$0.00
3077F		63	61	$0.00
90461		14	14	$0.00
90685		12	12	$0.00
3046F		12	12	$0.00
1036F		4,088	3,755	$0.00
3075F		285	279	$0.00
3079F		759	732	$0.00
G8428	Cur meds not document	522	492	$0.00
G8754	Dias bp less 90	777	722	$0.00
G8420	Calc bmi norm parameters	44	39	$0.00
G8419	Calc bmi out nrm param nof/u	98	93	$0.00
3080F		13	13	$0.00
3074F		2,954	2,810	$0.00
3044F		12	12	$0.00

Medicaid Provider Spending