DAVENPORT PEDIATRICS

$8.00M

Total Medicaid Paid

209,216

Total Claims

191,030

Beneficiaries

51

Codes Billed

2019-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		28,596	24,885	$3.04M
99213		25,841	21,733	$1.83M
99392		6,126	5,916	$752K
99391		5,698	5,556	$711K
99393		5,606	5,525	$605K
99394		3,909	3,850	$454K
90460		17,282	16,832	$263K
87804		11,398	5,474	$78K
87811		4,948	4,731	$71K
99381		664	598	$59K
87880		7,691	7,231	$44K
99215	Prolong outpt/office vis	122	120	$19K
85018		18,884	18,396	$12K
81003		10,487	10,035	$10K
99383		81	81	$9K
86580		3,922	3,848	$9K
83655		1,981	1,932	$8K
96110		3,232	3,106	$6K
99204		37	33	$5K
0071A		118	106	$3K
90710		1,241	1,208	$2K
0072A		50	50	$2K
94640		418	392	$1K
90680		2,956	2,883	$1K
90633		2,201	2,104	$663.10
90686		4,725	4,617	$637.89
0003A		16	16	$434.92
90671		1,301	1,272	$222.61
90656		345	343	$200.08
36416		16,879	16,419	$158.44
G0008	Admin influenza virus vac	14	14	$103.32
90651		1,107	1,083	$35.00
90700		336	321	$28.82
90734		1,137	1,115	$24.01
90648		4,469	4,331	$12.93
G9903	Pt scrn tbco id as non user	2,002	1,943	$6.40
J7613	Albuterol non-comp unit	415	386	$4.47
91307		183	169	$0.26
90715		315	312	$0.12
91300		39	39	$0.10
90696		348	333	$0.04
90723		3,452	3,342	$0.00
96127		1,263	1,242	$0.00
G8510	Scr dep neg, no plan reqd	3,453	3,301	$0.00
90620		365	358	$0.00
90716		30	30	$0.00
90670		2,990	2,901	$0.00
G8431	Pos clin depres scrn f/u doc	439	414	$0.00
99173		13	13	$0.00
90707		57	57	$0.00
90685		34	34	$0.00

Medicaid Provider Spending