HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL

$1.49M

Total Medicaid Paid

37,413

Total Claims

31,277

Beneficiaries

56

Codes Billed

2018-01

First Month

2021-06

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		5,146	4,404	$433K
99284		3,662	2,844	$389K
99285		1,607	1,202	$225K
80053		2,428	2,081	$70K
85025		2,940	2,520	$46K
99211		3,699	3,288	$38K
36415		5,159	4,373	$34K
96372		1,329	948	$31K
99282		431	394	$27K
96361		344	272	$19K
86140		996	819	$17K
93000		228	186	$17K
93005		543	430	$15K
87804		770	353	$13K
71046		218	189	$10K
83605		152	127	$9K
96374		295	248	$8K
81001		1,103	995	$8K
J1885	Ketorolac tromethamine inj	701	628	$6K
83690		377	337	$6K
81003		656	547	$6K
87260		205	201	$6K
96375		81	67	$5K
A0999	Unlisted ambulance service	17	14	$4K
87086		192	180	$4K
70450		14	12	$4K
87430		310	286	$4K
87635		42	42	$4K
84484		250	208	$3K
A0427	Als1-emergency	21	17	$3K
97110		49	13	$3K
80048		77	70	$3K
A0425	Ground mileage	42	34	$3K
A9270	Non-covered item or service	2,462	2,174	$2K
87070		108	96	$1K
87276		49	47	$1K
87275		49	47	$1K
85379		17	13	$879.36
J7030	Normal saline solution infus	74	68	$871.62
82150		73	67	$746.29
80306		31	26	$647.51
81025		80	74	$623.28
82550		29	25	$456.30
83735		53	42	$437.04
84443		12	12	$428.62
85027		15	14	$424.01
93010		15	14	$373.37
94640		14	12	$267.02
J1100	Dexamethasone sodium phos	14	13	$173.03
85018		18	18	$164.39
85610		27	24	$158.39
87449		18	18	$149.76
90686		19	12	$149.45
J2405	Ondansetron hcl injection	12	12	$92.23
G0008	Admin influenza virus vac	19	12	$64.01
87651		121	108	$59.88

Medicaid Provider Spending