ROCKY MOUNTAIN LABORATORIES LLC

$2.05M

Total Medicaid Paid

72,578

Total Claims

58,691

Beneficiaries

52

Codes Billed

2022-08

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
87798		10,090	7,957	$869K
87801		7,435	6,344	$318K
87481		5,140	4,378	$175K
G0480	Drug test def 1-7 classes	3,666	1,949	$165K
80307		3,410	1,740	$133K
87653		4,999	4,263	$63K
87631		3,349	2,980	$49K
87500		2,633	2,314	$35K
87641		2,634	2,315	$33K
87511		2,295	1,883	$26K
87563		2,200	1,753	$25K
87529		1,334	1,162	$24K
87640		1,688	1,493	$24K
87661		2,310	1,898	$24K
87637		477	461	$15K
87505		291	273	$15K
87491		1,555	1,352	$14K
87591		1,426	1,249	$13K
87651		1,208	1,064	$9K
87506		48	47	$4K
80053		1,230	993	$3K
82306		460	384	$2K
80061		796	681	$2K
U0004	Cov-19 test non-cdc hgh thru	33	30	$2K
85025		1,095	877	$2K
83036		841	727	$2K
81003		2,546	2,147	$1K
36415		3,226	2,522	$1K
80050		52	52	$1K
84443		552	438	$1K
87635		72	61	$585.04
84439		213	165	$443.44
82607		177	150	$333.04
80047		117	95	$314.72
82570		188	175	$239.56
83735		138	98	$218.52
82044		193	172	$198.57
86481		34	18	$102.22
84481		41	35	$96.16
P9603	One-way allow prorated miles	1,737	1,466	$95.19
82746		28	28	$94.39
83540		53	47	$65.64
82728		37	29	$65.10
84436		60	51	$58.86
85652		120	82	$51.09
84550		101	91	$30.80
U0005	Infec agen detec ampli probe	30	27	$25.00
G0471	Ven blood coll snf/hha	154	110	$4.22
P9604	One-way allow prorated trip	30	29	$0.00
87541		12	12	$0.00
87486		12	12	$0.00
87581		12	12	$0.00

Medicaid Provider Spending