SPANISH PEAKS NEW ALTERNATIVES, INC.

$2.38M

Total Medicaid Paid

43,064

Total Claims

35,570

Beneficiaries

43

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		16,953	13,915	$1.28M
99213		14,385	11,676	$807K
99204		611	583	$75K
99205	Prolong outpt/office vis	198	190	$32K
J2315	Naltrexone, depot form	26	26	$31K
81025		3,506	2,256	$27K
H0049	Alcohol/drug screening	1,582	1,540	$15K
99212		464	418	$15K
99203		168	157	$14K
G8510	Scr dep neg, no plan reqd	1,317	1,263	$14K
G8431	Pos clin depres scrn f/u doc	424	411	$12K
90832		243	230	$12K
96372		935	804	$12K
99354		131	126	$9K
90471		418	405	$8K
99215	Prolong outpt/office vis	68	67	$8K
90686		215	209	$3K
99396		22	21	$2K
90674		85	85	$1K
90756		77	77	$1K
99395		16	16	$1K
90658		79	77	$1K
99406		111	101	$988.67
96127		81	77	$806.72
J1040	Methylprednisolone 80 mg inj	99	81	$796.09
87426		15	14	$459.94
Q0091	Obtaining screen pap smear	12	12	$458.52
J3420	Vitamin b12 injection	430	380	$430.55
93000		31	26	$396.14
98926		19	12	$301.35
87804		13	12	$245.76
81002		82	70	$245.57
90656		12	12	$223.50
36415		60	56	$155.00
99415	Prolong outpt/office vis	17	17	$113.76
J1010	Inj, methylpred acetate 1 mg	13	12	$106.08
J3301	Triamcinolone acet inj nos	21	16	$75.79
3078F		13	13	$0.00
3079F		13	13	$0.00
3074F		56	54	$0.00
H0004	Alcohol and/or drug services	17	15	$0.00
3075F		12	12	$0.00
H0002	Alcohol and/or drug screenin	14	13	$0.00

Medicaid Provider Spending