SOUTH PADRE ISLAND PEDIATRIC CENTER

$730K

Total Medicaid Paid

57,934

Total Claims

50,648

Beneficiaries

51

Codes Billed

2018-02

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		13,874	10,909	$136K
87428		1,322	1,246	$101K
99394		1,030	1,010	$100K
99393		994	972	$93K
99214		4,729	4,073	$65K
99392		587	577	$51K
87426		1,055	971	$44K
90471		3,431	3,313	$42K
90472		2,640	1,410	$26K
99391		310	299	$26K
S8301	Infect control supplies nos	5,785	4,949	$23K
99051		2,773	2,476	$5K
99050		161	153	$4K
96110		450	436	$4K
99212		483	466	$3K
96160		1,640	1,420	$2K
0072A		35	35	$2K
0071A		42	26	$1K
87804		270	124	$820.10
87880		291	283	$818.17
0001A		13	13	$480.00
90620		45	40	$434.80
90651		108	108	$290.27
G8510	Scr dep neg, no plan reqd	32	27	$245.09
99215	Prolong outpt/office vis	12	12	$240.46
90734		92	91	$158.53
92552		59	59	$148.75
90688		295	288	$140.43
92551		2,373	2,331	$65.96
90686		504	484	$59.42
G9716	Bmi doc onl fup not cmpltd	173	172	$16.50
96161		1,272	1,065	$2.54
S0302	Completed epsdt	2,229	2,169	$0.00
G0439	Ppps, subseq visit	1,745	1,712	$0.00
G0447	Behavior counsel obesity 15m	1,419	1,408	$0.00
96127		1,096	1,053	$0.00
90696		13	13	$0.00
91307		111	92	$0.00
90680		30	26	$0.00
96372		13	13	$0.00
90656		34	34	$0.00
90619		26	26	$0.00
90657		14	14	$0.00
99173		2,470	2,421	$0.00
90670		235	222	$0.00
G0270	Mnt subs tx for change dx	1,438	1,428	$0.00
90648		69	67	$0.00
90671		56	56	$0.00
91300		15	15	$0.00
90715		29	29	$0.00
90633		12	12	$0.00

Medicaid Provider Spending