KO OLAULOA HEALTH CENTER

$3.51M

Total Medicaid Paid

50,736

Total Claims

43,665

Beneficiaries

44

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		12,388	10,783	$1.95M
99214		4,471	3,868	$659K
99212		2,230	2,065	$383K
D9999		845	625	$158K
90837		806	484	$123K
99391		367	328	$62K
D0140		351	209	$62K
99392		150	137	$24K
99215	Prolong outpt/office vis	128	106	$22K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	1,541	1,158	$21K
99393		115	111	$19K
99394		53	47	$8K
90460		2,116	1,292	$3K
99203		14	12	$2K
99204		20	13	$2K
90834		18	12	$2K
86580		209	184	$2K
90471		40	39	$1K
90461		470	383	$1K
36415		27	25	$406.12
99211		18	17	$282.03
96127		38	27	$222.80
3008F		11,717	10,396	$190.77
90670		47	45	$92.44
1126F		814	737	$0.00
3074F		2,447	2,215	$0.00
1036F		802	689	$0.00
1125F		1,838	1,660	$0.00
3079F		202	191	$0.00
90688		36	35	$0.00
3044F		38	31	$0.00
3075F		57	52	$0.00
90698		46	44	$0.00
90744		14	13	$0.00
90680		14	13	$0.00
3080F		13	13	$0.00
1159F		1,614	1,443	$0.00
1160F		1,990	1,787	$0.00
3078F		2,307	2,087	$0.00
3725F		179	163	$0.00
3077F		93	82	$0.00
90633		15	13	$0.00
90734		20	16	$0.00
90715		18	15	$0.00

Medicaid Provider Spending