PELLA REGIONAL HEALTH CENTER

$1.92M

Total Medicaid Paid

58,929

Total Claims

49,915

Beneficiaries

53

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		4,113	3,565	$528K
99284		1,516	1,289	$344K
80053		6,809	5,863	$266K
36415		26,248	21,816	$189K
99282		3,140	2,773	$188K
85025		9,341	7,920	$149K
84443		1,314	1,154	$35K
0202U		120	107	$26K
71046		450	403	$25K
96374		410	364	$24K
J7030	Normal saline solution infus	703	568	$20K
80048		483	442	$16K
93005		315	268	$16K
80061		392	346	$14K
83036		487	445	$12K
87086		380	316	$7K
86140		364	309	$7K
96375		86	80	$5K
85652		345	286	$5K
96361		153	131	$5K
87502		182	171	$5K
97110		51	13	$4K
81001		233	185	$3K
84484		110	92	$3K
0241U		42	39	$2K
81003		208	180	$2K
84703		62	55	$2K
87798		15	13	$2K
82150		72	65	$2K
J7120	Ringers lactate infusion	45	38	$1K
83690		91	83	$1K
71045		25	24	$1K
81015		102	81	$1K
83605		41	37	$1K
87210		65	52	$1K
74019		13	12	$960.32
87581		15	13	$838.88
87486		15	13	$838.88
J2704	Inj, propofol, 10 mg	51	37	$625.76
87635		14	13	$612.87
84145		12	12	$590.54
59025		20	12	$545.31
G0463	Hospital outpt clinic visit	16	12	$453.84
87899		14	12	$385.13
82947		27	26	$356.10
85027		14	12	$301.19
J1885	Ketorolac tromethamine inj	28	24	$249.37
87633		15	13	$205.44
87428		22	18	$204.31
G0435	Oral hiv-1/hiv-2 screen	14	12	$166.20
J2405	Ondansetron hcl injection	15	12	$118.91
A9270	Non-covered item or service	95	77	$95.00
J1100	Dexamethasone sodium phos	16	12	$86.94

Medicaid Provider Spending