PHC-FORT MORGAN INC

$1.30M

Total Medicaid Paid

23,857

Total Claims

22,009

Beneficiaries

50

Codes Billed

2018-01

First Month

2022-04

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		4,660	4,457	$579K
99284		4,540	4,311	$423K
80053		2,517	2,327	$66K
99282		496	471	$59K
96361		161	147	$37K
87086		682	642	$25K
99285		313	288	$21K
36415		2,936	2,596	$12K
0011A		109	97	$9K
U0003	Cov-19 amp prb hgh thruput	122	110	$8K
92507		71	26	$8K
0012A		90	83	$7K
84443		486	467	$7K
85025		3,331	3,041	$7K
86701		108	105	$4K
80307		68	65	$4K
83036		126	124	$4K
U0005	Infec agen detec ampli probe	77	72	$4K
87070		80	76	$3K
87635		58	57	$3K
59025		16	15	$3K
86803		124	117	$2K
80055		55	54	$2K
87653		18	15	$1K
C9803	Hopd covid-19 spec collect	66	64	$858.60
96374		396	367	$597.33
80306		25	24	$579.30
87081		34	30	$569.36
87636		13	13	$297.55
80061		13	13	$252.36
97530		33	12	$175.47
87426		46	45	$170.16
87804		430	222	$153.72
71046		43	42	$133.69
96375		58	54	$109.96
82950		12	12	$48.20
J7030	Normal saline solution infus	312	289	$0.00
J2405	Ondansetron hcl injection	12	12	$0.00
93005		123	116	$0.00
81003		28	27	$0.00
Q9967	Locm 300-399mg/ml iodine,1ml	13	13	$0.00
81001		592	553	$0.00
71045		86	78	$0.00
87430		49	46	$0.00
J1885	Ketorolac tromethamine inj	51	50	$0.00
Q0162	Ondansetron oral	40	39	$0.00
J2001	Lidocaine injection	14	14	$0.00
96372		59	52	$0.00
83690		46	43	$0.00
G0378	Hospital observation per hr	19	16	$0.00

Medicaid Provider Spending