SOUTHERN DOMINION HEALTH SYSTEM, INC.
NPI: 1497969091
· VICTORIA, VA 23974
· 261QF0400X
$810K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,352 |
$91K |
| 2019 |
4,165 |
$108K |
| 2020 |
2,070 |
$63K |
| 2021 |
3,809 |
$130K |
| 2022 |
5,600 |
$161K |
| 2023 |
7,750 |
$177K |
| 2024 |
3,411 |
$80K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
10,864 |
9,296 |
$475K |
| 99214 |
|
3,737 |
3,372 |
$174K |
| G0467 |
Fqhc visit, estab pt |
3,504 |
2,556 |
$50K |
| 87426 |
|
656 |
607 |
$18K |
| 87428 |
|
877 |
837 |
$17K |
| 99212 |
|
464 |
439 |
$15K |
| 87880 |
|
1,089 |
1,031 |
$14K |
| 1000F |
|
1,556 |
1,486 |
$6K |
| 3008F |
|
1,416 |
1,342 |
$5K |
| 1036F |
|
982 |
909 |
$4K |
| 90686 |
|
313 |
300 |
$4K |
| 1170F |
|
788 |
725 |
$4K |
| 87804 |
|
278 |
252 |
$3K |
| 1034F |
|
608 |
565 |
$3K |
| 3351F |
|
851 |
812 |
$3K |
| 87807 |
|
157 |
145 |
$2K |
| 3074F |
|
260 |
249 |
$2K |
| 3078F |
|
254 |
242 |
$2K |
| 4004F |
|
248 |
237 |
$1K |
| 99393 |
|
14 |
13 |
$1K |
| 99392 |
|
12 |
12 |
$864.36 |
| 3017F |
|
124 |
109 |
$825.00 |
| 99202 |
|
14 |
13 |
$735.03 |
| 81003 |
|
463 |
425 |
$702.83 |
| 0012A |
|
29 |
28 |
$693.39 |
| 99000 |
|
389 |
368 |
$692.56 |
| 83036 |
|
292 |
250 |
$589.28 |
| 90471 |
|
357 |
351 |
$558.97 |
| 0011A |
|
33 |
33 |
$483.30 |
| 3079F |
|
45 |
44 |
$400.00 |
| 99177 |
|
112 |
111 |
$320.78 |
| 2022F |
|
53 |
46 |
$300.00 |
| 96372 |
|
25 |
25 |
$252.83 |
| 2028F |
|
13 |
12 |
$100.00 |
| 81025 |
|
15 |
15 |
$98.60 |
| 3075F |
|
15 |
14 |
$75.00 |
| 3077F |
|
14 |
14 |
$75.00 |
| 99406 |
|
13 |
13 |
$64.44 |
| G0008 |
Admin influenza virus vac |
64 |
51 |
$12.16 |
| 91301 |
|
79 |
76 |
$0.60 |
| 90472 |
|
59 |
57 |
$0.00 |
| 90662 |
|
21 |
16 |
$0.00 |