MONTECRISTO MEDICAL PC

$98K

Total Medicaid Paid

60,614

Total Claims

58,561

Beneficiaries

72

Codes Billed

2019-03

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		4,229	4,085	$35K
99213		3,828	3,666	$10K
99212		1,833	1,705	$9K
93000		714	711	$7K
G0447	Behavior counsel obesity 15m	3,617	3,482	$6K
99396		852	851	$5K
92551		1,172	1,164	$5K
97803		2,200	2,090	$3K
99395		503	503	$2K
99385		50	49	$2K
96156		1,287	1,276	$2K
99000		4,312	4,205	$2K
99215	Prolong outpt/office vis	300	284	$2K
G8510	Scr dep neg, no plan reqd	1,345	1,336	$943.55
80061		389	376	$857.36
81000		2,001	1,941	$777.82
99393		84	84	$727.93
99394		115	115	$710.44
99401		312	304	$607.50
90471		431	417	$537.31
92081		300	300	$520.00
80053		422	413	$491.22
G0444	Depression screen annual	1,466	1,459	$380.00
97802		802	798	$376.20
36415		1,512	1,469	$338.40
99173		622	617	$259.62
83036		318	309	$169.04
3008F		4,976	4,795	$165.04
96127		102	101	$164.28
90791		146	143	$150.00
90472		48	41	$148.56
99386		12	12	$143.40
3078F		3,864	3,743	$134.53
85018		392	383	$131.78
3074F		3,550	3,439	$131.53
82962		445	430	$121.80
G8431	Pos clin depres scrn f/u doc	317	313	$113.96
1160F		3,576	3,315	$75.00
82270		110	109	$47.63
99366		14	13	$36.71
90649		12	12	$27.00
99211		73	72	$20.80
3079F		602	583	$20.01
92552		14	14	$16.52
99442		55	54	$5.00
1159F		3,713	3,449	$2.70
3044F		295	288	$2.00
1125F		219	219	$1.80
3075F		472	466	$0.01
96160		656	655	$0.00
3077F		471	452	$0.00
3050F		72	72	$0.00
1158F		28	28	$0.00
G8752	Sys bp less 140	60	60	$0.00
3015F		156	148	$0.00
G0101	Ca screen;pelvic/breast exam	53	53	$0.00
G8511	Scr dep pos, no plan doc rng	12	12	$0.00
82274		45	45	$0.00
G0446	Intens behave ther cardio dx	24	24	$0.00
4004F		22	22	$0.00
G8754	Dias bp less 90	76	76	$0.00
4050F		116	115	$0.00
1126F		368	367	$0.00
3017F		170	169	$0.00
3049F		89	89	$0.00
1036F		66	66	$0.00
99441		30	30	$0.00
88150		13	13	$0.00
99406		22	22	$0.00
3080F		15	13	$0.00
3014F		12	12	$0.00
3048F		15	15	$0.00

Medicaid Provider Spending