PENA, CLOTILDE

$38K

Total Medicaid Paid

11,605

Total Claims

6,268

Beneficiaries

49

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
90460		1,236	1,220	$19K
G0270	Mnt subs tx for change dx	282	282	$9K
83655		234	234	$3K
92587		116	116	$3K
96110		127	127	$2K
99213		139	131	$1K
90461		435	432	$452.72
G0444	Depression screen annual	14	14	$293.02
90671		99	99	$277.20
S9451	Exercise class	275	275	$110.00
90686		85	85	$38.00
90656		63	63	$0.01
1033F		306	306	$0.00
99080		5,630	320	$0.00
99408		15	15	$0.00
90715		16	16	$0.00
G8417	Calc bmi abv up param f/u	36	36	$0.00
99392		141	141	$0.00
G9622	No unheal etoh user	15	15	$0.00
99393		33	33	$0.00
3725F		14	14	$0.00
3016F		15	15	$0.00
99173		35	35	$0.00
90633		30	30	$0.00
G0445	High inten beh couns std 30m	28	28	$0.00
96160		16	16	$0.00
S9449	Weight mgmt class	41	41	$0.00
90710		12	12	$0.00
90734		12	12	$0.00
36415		111	111	$0.00
90660		12	12	$0.00
97802		353	353	$0.00
S9452	Nutrition class	41	41	$0.00
2001F		195	195	$0.00
1000F		320	320	$0.00
H0001	Alcohol and/or drug assess	15	15	$0.00
90680		12	12	$0.00
G8420	Calc bmi norm parameters	131	131	$0.00
1031F		307	307	$0.00
3008F		195	195	$0.00
2010F		137	137	$0.00
2000F		167	167	$0.00
G8510	Scr dep neg, no plan reqd	14	14	$0.00
96127		14	14	$0.00
90619		12	12	$0.00
90698		26	26	$0.00
G9275	Doc of non tobacco user	12	12	$0.00
1220F		14	14	$0.00
90620		17	17	$0.00

Medicaid Provider Spending