MIDWEST DIVISION-OPRMC LLC

$2.62M

Total Medicaid Paid

43,396

Total Claims

40,177

Beneficiaries

61

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		17,672	16,818	$1.48M
99284		7,342	6,816	$728K
99282		2,765	2,660	$187K
85027		5,644	5,021	$52K
99281		604	576	$28K
80053		2,190	1,974	$26K
99285		215	190	$25K
G0378	Hospital observation per hr	249	132	$23K
96374		991	922	$19K
83735		139	98	$9K
74177		76	74	$6K
80048		117	94	$5K
87804		344	337	$5K
96375		131	122	$3K
70450		78	70	$3K
87430		375	354	$3K
87426		94	89	$2K
84484		149	103	$2K
87591		42	42	$1K
87491		42	42	$1K
93005		174	151	$1K
87637		16	16	$1K
96372		99	95	$1K
81025		195	189	$1K
87428		55	46	$1K
87081		172	170	$959.14
71046		116	111	$876.71
83880		54	49	$834.35
82553		72	61	$804.35
71045		199	170	$789.17
83690		124	112	$702.05
U0002	Covid-19 lab test non-cdc	26	26	$666.33
96361		58	56	$643.82
36415		1,131	995	$540.29
81001		220	208	$529.20
82550		74	63	$454.44
84703		66	61	$427.06
87086		49	48	$398.16
87807		32	32	$317.98
94640		44	32	$250.80
85379		34	32	$248.75
74018		35	33	$243.18
85610		65	56	$209.50
J1885	Ketorolac tromethamine inj	100	84	$187.72
80306		14	13	$176.69
84443		14	12	$161.45
81003		255	238	$158.48
85730		48	43	$155.98
J2405	Ondansetron hcl injection	160	138	$125.22
86850		14	14	$86.66
J0696	Ceftriaxone sodium injection	31	29	$69.74
86901		14	14	$67.18
86900		14	14	$52.75
87210		12	12	$44.74
J1200	Diphenhydramine hcl injectio	39	31	$36.95
J2550	Promethazine hcl injection	16	14	$28.39
J2060	Lorazepam injection	19	15	$18.45
J7050	Normal saline solution infus	73	58	$6.67
A9270	Non-covered item or service	118	21	$0.00
Q0162	Ondansetron oral	71	66	$0.00
99212		15	15	$0.00

Medicaid Provider Spending