CALAGOS, MA. JESUSA

$274K

Total Medicaid Paid

50,217

Total Claims

48,577

Beneficiaries

50

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		3,784	3,519	$70K
90460		4,395	4,273	$48K
99214		1,382	1,310	$35K
99392		1,169	1,162	$22K
99393		869	867	$17K
99391		835	793	$14K
96110		3,092	3,039	$14K
99401		3,887	3,825	$11K
92587		2,083	2,081	$11K
99212		437	425	$6K
99394		232	232	$5K
G0447	Behavior counsel obesity 15m	360	360	$5K
90461		1,279	1,254	$4K
97802		2,574	2,570	$4K
S9451	Exercise class	2,305	2,302	$3K
87880		130	124	$1K
G0444	Depression screen annual	228	228	$1K
90670		105	105	$625.55
90686		905	905	$586.25
G0442	Annual alcohol screen 15 min	46	46	$531.92
G8510	Scr dep neg, no plan reqd	403	403	$372.20
G8431	Pos clin depres scrn f/u doc	416	416	$357.68
99173		215	215	$335.97
G2023	Specimen collect covid-19	125	120	$199.50
90656		83	82	$156.45
90685		186	185	$123.51
87110		12	12	$99.17
99072		5,390	4,893	$60.01
90707		27	27	$40.00
H0001	Alcohol and/or drug assess	14	14	$10.00
3078F		577	577	$0.00
1160F		3,733	3,510	$0.00
1159F		3,720	3,497	$0.00
3725F		180	180	$0.00
G8417	Calc bmi abv up param f/u	448	448	$0.00
90700		12	12	$0.00
90633		25	25	$0.00
90680		13	13	$0.00
3074F		578	578	$0.00
G8420	Calc bmi norm parameters	1,049	1,048	$0.00
1000F		156	156	$0.00
3008F		2,213	2,210	$0.00
1126F		145	140	$0.00
1036F		182	182	$0.00
99070		91	88	$0.00
90716		25	25	$0.00
90698		51	51	$0.00
90744		14	13	$0.00
1125F		14	14	$0.00
99000		23	23	$0.00

Medicaid Provider Spending