NORTH SIDE CHRISTIAN HEALTH CENTER

$4.71M

Total Medicaid Paid

49,730

Total Claims

44,075

Beneficiaries

60

Codes Billed

2018-02

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic service	24,743	20,160	$4.71M
99214		2,391	2,156	$2K
99393		276	275	$1K
99213		1,974	1,845	$1K
99173		1,711	1,658	$430.80
92551		1,573	1,528	$232.00
G0467	Fqhc visit, estab pt	15	13	$173.71
99442		473	439	$140.25
90460		801	774	$102.85
3074F		2,730	2,642	$97.96
90471		218	210	$92.00
99392		110	109	$80.00
3079F		413	404	$64.65
3078F		1,177	1,122	$62.61
90686		215	208	$60.00
0071A		17	13	$40.00
36415		509	491	$31.40
3075F		263	254	$14.69
96127		738	715	$10.00
3080F		114	112	$10.00
90472		31	31	$9.00
91307		19	15	$0.01
3077F		344	332	$0.01
G8510	Scr dep neg, no plan reqd	932	907	$0.00
3008F		3,544	3,380	$0.00
96110		430	427	$0.00
D0150		132	132	$0.00
D1330		120	119	$0.00
99441		44	37	$0.00
D0140		185	179	$0.00
D1310		119	117	$0.00
D1206		376	372	$0.00
90744		17	16	$0.00
90657		29	27	$0.00
D0120		48	48	$0.00
87635		32	24	$0.00
85018		13	13	$0.00
G0008	Admin influenza virus vac	33	32	$0.00
90656		44	44	$0.00
3044F		16	15	$0.00
90651		13	12	$0.00
G8431	Pos clin depres scrn f/u doc	700	679	$0.00
99394		167	162	$0.00
G9920	Scrning perf and negative	705	682	$0.00
D0220		137	133	$0.00
D1120		274	271	$0.00
G9919	Scrn nd pos nd prov of rec	167	166	$0.00
1160F		95	89	$0.00
D0274		132	131	$0.00
90461		40	40	$0.00
90658		14	14	$0.00
1159F		113	102	$0.00
81025		13	12	$0.00
96160		33	33	$0.00
D1110		77	77	$0.00
G0444	Depression screen annual	28	26	$0.00
90734		14	14	$0.00
99212		13	12	$0.00
99395		12	12	$0.00
99391		14	13	$0.00

Medicaid Provider Spending