PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH, LLC · NPI 1568705267

$857K

Total Medicaid Paid

40,499

Total Claims

35,561

Beneficiaries

49

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		6,166	5,674	$283K
99284		4,192	3,855	$198K
99285		3,035	2,660	$138K
80307		722	652	$41K
80053		3,009	2,624	$27K
87428		779	697	$25K
85025		4,661	4,082	$23K
96374		783	692	$16K
96361		686	590	$12K
81001		2,966	2,679	$11K
93005		1,005	790	$11K
96375		339	296	$9K
87804		553	270	$9K
71045		658	565	$9K
80048		662	582	$8K
U0003	Cov-19 amp prb hgh thruput	133	119	$6K
96372		245	174	$4K
84484		477	366	$4K
81025		430	371	$4K
80076		311	276	$3K
36415		5,677	4,895	$2K
83690		342	292	$2K
70450		12	12	$1K
87880		133	132	$1K
71046		63	60	$1K
87070		121	120	$1K
94640		83	65	$905.33
83735		132	116	$849.75
85610		156	138	$688.55
82550		94	78	$612.76
85730		123	107	$578.30
87086		50	47	$525.62
83880		33	27	$513.72
84443		35	29	$462.55
U0005	Infec agen detec ampli probe	31	24	$420.64
87426		14	12	$311.45
99281		18	17	$252.66
87420		14	13	$153.21
C9803	Hopd covid-19 spec collect	133	120	$121.19
J2405	Ondansetron hcl injection	161	141	$120.15
85027		23	16	$94.64
83605		18	12	$85.31
J1885	Ketorolac tromethamine inj	51	46	$62.60
85007		37	29	$23.29
81003		14	13	$17.61
J7030	Normal saline solution infus	925	812	$12.72
Q0163	Diphenhydramine hcl 50mg	102	97	$4.42
Q0162	Ondansetron oral	16	14	$0.26
J7120	Ringers lactate infusion	76	63	$0.00

Medicaid Provider Spending