NORTHEASTERN HEALTH SYSTEM
NPI: 1689338519
· TAHLEQUAH, OK 74464
· 101YA0400X
$650K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
2,962 |
$67K |
| 2023 |
21,895 |
$418K |
| 2024 |
14,592 |
$164K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0109 |
Methadone oral 5mg |
27,430 |
1,468 |
$203K |
| J0574 |
Bupren/nal 6.1 to 10mg bupre |
5,278 |
271 |
$116K |
| 99214 |
|
975 |
608 |
$110K |
| H0004 |
Alcohol and/or drug services |
1,684 |
898 |
$86K |
| G0480 |
Drug test def 1-7 classes |
315 |
297 |
$32K |
| 99211 |
|
1,354 |
1,060 |
$27K |
| 80307 |
|
481 |
387 |
$26K |
| T1017 |
Targeted case management |
757 |
561 |
$24K |
| 99215 |
Prolong outpt/office vis |
65 |
39 |
$10K |
| H2015 |
Comp comm supp svc, 15 min |
474 |
268 |
$6K |
| 80305 |
|
326 |
311 |
$4K |
| J0571 |
Buprenorphine oral 1mg |
211 |
13 |
$3K |
| H2017 |
Psysoc rehab svc, per 15 min |
79 |
42 |
$596.63 |
| H0002 |
Alcohol and/or drug screenin |
20 |
20 |
$498.40 |