KIET A.T. TON, MD, CORP.

$22K

Total Medicaid Paid

13,345

Total Claims

13,073

Beneficiaries

54

Codes Billed

2021-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		2,565	2,483	$10K
96156		920	914	$5K
99490	Ccm add 20min	192	191	$2K
90756		84	83	$1K
90686		34	34	$820.36
99483	Prolong outpt/office vis	51	51	$593.07
G0444	Depression screen annual	548	544	$470.09
99213		296	282	$383.49
99215	Prolong outpt/office vis	158	158	$375.00
99204		184	180	$356.26
90658		33	33	$290.24
99203		93	92	$237.29
G8510	Scr dep neg, no plan reqd	618	612	$148.02
90471		174	172	$105.30
99223	Prolong inpt eval add15 m	12	12	$80.10
94760		604	590	$50.14
G0136	Adm of pa/n assess 5-15 m	150	149	$50.00
92551		64	64	$49.68
G0442	Annual alcohol screen 15 min	84	84	$47.26
99497		26	26	$37.29
96127		18	18	$6.20
3008F		252	249	$0.00
3075F		122	122	$0.00
2010F		232	227	$0.00
2000F		804	782	$0.00
3074F		700	669	$0.00
G9664	Taking statin or rec'd order	163	161	$0.00
1170F		71	69	$0.00
99205	Prolong outpt/office vis	26	26	$0.00
3079F		139	139	$0.00
1220F		129	127	$0.00
36415		69	69	$0.00
1030F		230	225	$0.00
1036F		256	254	$0.00
44388		16	16	$0.00
1126F		267	262	$0.00
1101F		155	154	$0.00
3080F		13	13	$0.00
3044F		14	13	$0.00
4010F		12	12	$0.00
1022F		12	12	$0.00
3725F		345	342	$0.00
99396		255	252	$0.00
1159F		308	304	$0.00
1003F		202	202	$0.00
G8427	Docrev cur meds by elig clin	43	42	$0.00
1160F		308	304	$0.00
3016F		280	274	$0.00
1090F		121	120	$0.00
3078F		706	678	$0.00
G8482	Flu immunize order/admin	84	81	$0.00
3720F		24	24	$0.00
3288F		64	64	$0.00
3077F		15	13	$0.00

Medicaid Provider Spending