DO JACLYNN MD INC.

$460K

Total Medicaid Paid

67,123

Total Claims

61,851

Beneficiaries

49

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		18,075	14,992	$84K
96156		4,112	4,089	$74K
G9920	Scrning perf and negative	3,042	3,012	$65K
99395		1,757	1,461	$48K
96110		556	555	$31K
99214		6,327	5,900	$31K
96151		1,461	1,455	$12K
92551		824	819	$11K
88150		1,826	1,806	$11K
99396		2,228	1,734	$10K
G0442	Annual alcohol screen 15 min	4,850	4,825	$10K
99394		178	170	$10K
90688		691	688	$9K
96372		1,393	1,381	$6K
90756		357	355	$5K
81000		894	890	$5K
H0049	Alcohol/drug screening	432	430	$5K
90656		285	285	$4K
99203		270	264	$3K
G2012	Brief check in by md/qhp	3,944	3,568	$3K
99406		3,630	3,604	$3K
85018		750	748	$2K
99212		542	523	$2K
90674		124	124	$2K
96150		162	162	$2K
93000		108	107	$2K
90686		128	128	$2K
85014		174	173	$2K
99173		506	502	$1K
99215	Prolong outpt/office vis	136	136	$771.44
99211		247	237	$613.42
3074F		587	583	$548.94
99000		1,549	1,513	$528.72
0064A		12	12	$480.00
99385		31	25	$408.48
96127		53	51	$338.50
99442		3,256	2,929	$253.47
90660		37	37	$242.64
G8510	Scr dep neg, no plan reqd	75	75	$224.42
3078F		548	548	$203.25
85025		14	13	$124.82
99188		54	53	$54.00
90657		29	29	$36.00
G0444	Depression screen annual	115	112	$16.16
90471		617	611	$9.00
90658		14	14	$0.00
3075F		28	28	$0.00
99407		16	16	$0.00
3079F		79	79	$0.00

Medicaid Provider Spending