TOMBIGBEE HEALTHCARE AUTHORITY

$1.69M

Total Medicaid Paid

102,388

Total Claims

56,340

Beneficiaries

53

Codes Billed

2019-12

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic service	28,457	14,620	$1.56M
99214		13,074	7,226	$66K
99213		14,424	7,682	$38K
96372		7,562	3,635	$7K
85025		3,469	1,830	$3K
99204		21	21	$2K
90651		204	188	$1K
83036		1,947	1,085	$1K
99215	Prolong outpt/office vis	31	30	$1K
82947		3,115	1,799	$1K
J1885	Ketorolac tromethamine inj	3,307	1,941	$1K
92552		295	250	$1K
90633		213	195	$944.00
87804		2,872	1,511	$839.12
99393		252	200	$784.00
87635		2,801	1,567	$646.32
99173		1,352	934	$519.00
J1100	Dexamethasone sodium phos	3,150	1,857	$498.45
81002		2,170	1,220	$472.71
90688		27	27	$364.80
J1020	Methylprednisolone 20 mg inj	214	145	$352.12
99212		908	619	$343.91
87880		926	560	$256.96
90734		32	29	$224.00
90707		16	14	$112.00
90716		16	14	$112.00
87807		142	99	$66.72
87811		155	75	$25.00
90686		89	34	$20.53
36415		2,547	1,301	$13.80
J0696	Ceftriaxone sodium injection	426	219	$4.26
3078F		1,476	1,299	$0.00
3077F		275	253	$0.00
81025		349	187	$0.00
90461		403	75	$0.00
J3301	Triamcinolone acet inj nos	257	129	$0.00
83655		69	60	$0.00
99394		104	80	$0.00
99203		57	15	$0.00
90460		891	160	$0.00
90658		70	12	$0.00
90671		68	12	$0.00
71046		13	12	$0.00
36416		471	215	$0.00
3074F		1,723	1,515	$0.00
92551		943	584	$0.00
3075F		153	146	$0.00
3079F		558	517	$0.00
90647		64	12	$0.00
90471		46	12	$0.00
3044F		40	39	$0.00
82962		78	14	$0.00
3080F		66	65	$0.00

Medicaid Provider Spending