UKHS GREAT BEND, LLC

$520K

Total Medicaid Paid

43,386

Total Claims

33,837

Beneficiaries

59

Codes Billed

2018-08

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		3,529	3,282	$148K
99284		3,207	2,779	$109K
80053		9,111	6,167	$60K
85025		10,341	7,482	$33K
U0003	Cov-19 amp prb hgh thruput	536	529	$31K
87633		45	44	$18K
76816		397	365	$17K
99285		631	530	$15K
87081		1,889	1,858	$15K
U0005	Infec agen detec ampli probe	501	496	$10K
87276		477	459	$8K
96374		544	455	$8K
99282		167	152	$6K
87430		516	506	$6K
81001		1,795	1,611	$4K
87880		449	440	$4K
87804		181	176	$3K
87426		96	90	$3K
87088		202	190	$2K
76801		24	24	$2K
96372		68	52	$2K
71046		54	48	$2K
83615		330	185	$1K
84443		112	107	$1K
83735		347	147	$1K
96375		52	44	$1K
76805		12	12	$880.51
87086		95	92	$836.66
82728		104	99	$834.01
86850		87	86	$743.41
71045		104	89	$720.01
84439		71	69	$655.42
93005		113	80	$610.07
82607		98	93	$586.29
96361		45	39	$531.96
87635		14	13	$436.10
82746		68	64	$415.46
82378		46	43	$403.33
83550		91	86	$385.72
86901		54	53	$329.76
G0463	Hospital outpt clinic visit	12	12	$300.00
86900		54	53	$258.24
84484		56	39	$215.68
82950		25	25	$193.37
83540		91	86	$190.28
36415		5,843	3,846	$177.43
87340		14	14	$174.68
83036		29	28	$161.92
83605		45	37	$161.72
80305		15	14	$135.27
J1885	Ketorolac tromethamine inj	82	69	$132.70
86762		14	14	$107.91
80061		15	15	$94.48
86592		14	14	$75.57
82306		16	16	$62.98
86703		14	14	$52.32
J7030	Normal saline solution infus	217	182	$30.45
J7120	Ringers lactate infusion	16	12	$20.82
C9803	Hopd covid-19 spec collect	211	211	$0.00

Medicaid Provider Spending