MINIDOKA MEMORIAL HOSPITAL

$359K

Total Medicaid Paid

23,955

Total Claims

19,582

Beneficiaries

59

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		1,251	960	$86K
99282		1,009	777	$74K
99281		655	614	$35K
80053		3,828	3,092	$30K
99284		414	262	$24K
85025		3,613	2,742	$14K
87502		158	153	$11K
93005		519	442	$10K
36415		4,065	3,120	$7K
71046		608	554	$7K
87635		198	184	$6K
84443		582	559	$6K
92507		86	28	$6K
A0427	Als1-emergency	32	27	$3K
80048		523	437	$3K
80061		407	397	$3K
A0425	Ground mileage	83	68	$2K
87798		85	75	$2K
J2405	Ondansetron hcl injection	297	263	$2K
87651		62	60	$2K
93010		449	383	$2K
83605		261	229	$2K
83036		572	554	$2K
81003		559	517	$2K
81001		669	611	$2K
96372		14	14	$2K
84484		336	269	$2K
96361		14	12	$1K
96365		39	24	$1K
J1885	Ketorolac tromethamine inj	147	137	$1K
85610		471	387	$927.32
83690		152	140	$920.69
J3010	Fentanyl citrate injection	43	40	$680.31
87186		126	111	$600.75
87077		130	115	$599.86
70450		27	25	$574.95
86140		135	123	$569.70
85027		194	178	$569.61
87086		135	126	$507.21
82550		147	113	$501.09
82553		82	63	$468.63
86769		14	14	$454.92
71045		76	67	$322.64
96374		69	60	$268.34
81025		27	27	$201.50
87430		16	16	$201.46
J2704	Inj, propofol, 10 mg	138	122	$195.31
J2250	Inj midazolam hydrochloride	14	12	$182.12
80305		12	12	$140.54
85730		45	41	$126.27
82570		51	50	$109.23
85652		34	27	$90.91
90662		20	19	$60.69
85379		13	12	$50.51
J7030	Normal saline solution infus	29	14	$39.26
82043		12	12	$38.58
G0008	Admin influenza virus vac	20	19	$21.90
J0696	Ceftriaxone sodium injection	15	14	$18.99
A9270	Non-covered item or service	173	59	$18.63

Medicaid Provider Spending