URGENT CARE ENTERPRISE LLC

$11.58M

Total Medicaid Paid

243,034

Total Claims

203,066

Beneficiaries

40

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
S9083	Urgent care center global	61,021	55,807	$4.38M
99214		38,453	31,743	$2.44M
99213		26,462	22,801	$1.51M
99203		20,888	18,007	$1.28M
99204		11,769	10,401	$882K
87635		13,804	12,434	$374K
99202		3,200	2,825	$192K
87426		10,013	8,669	$164K
87428		5,675	4,946	$146K
87804		19,335	8,089	$73K
87880		16,198	13,769	$42K
99212		832	662	$27K
99215	Prolong outpt/office vis	287	260	$21K
96372		4,112	3,336	$18K
99205	Prolong outpt/office vis	140	125	$12K
99201		59	58	$4K
71046		704	596	$4K
81025		1,741	1,484	$3K
81002		3,739	3,143	$2K
73610		283	243	$2K
73630		214	178	$1K
69209		121	90	$915.68
93000		132	126	$724.74
94640		162	140	$717.79
J1100	Dexamethasone sodium phos	1,351	1,201	$567.08
87807		148	129	$478.97
J1885	Ketorolac tromethamine inj	599	517	$437.30
73140		65	60	$407.55
J0696	Ceftriaxone sodium injection	434	388	$254.98
73110		17	13	$105.21
86308		69	64	$97.63
73130		13	12	$42.51
S0119	Ondansetron 4 mg	47	44	$12.83
81003		139	57	$10.00
99000		433	360	$7.78
J7620	Albuterol ipratrop non-comp	16	14	$1.32
J7613	Albuterol non-comp unit	14	13	$0.96
99051		137	128	$0.00
A6449	Lt compres band >=3" <5"/yd	79	63	$0.00
J1040	Methylprednisolone 80 mg inj	129	71	$0.00

Medicaid Provider Spending