NORTHEAST VALLEY HEALTH CORPORATION

$2.11M

Total Medicaid Paid

28,344

Total Claims

26,529

Beneficiaries

39

Codes Billed

2018-01

First Month

2024-09

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	20,316	18,532	$1.96M
99392		746	745	$28K
99393		583	583	$25K
99394		336	335	$18K
90834		265	259	$15K
90832		380	379	$13K
99213		351	349	$11K
92551		1,095	1,095	$11K
99391		323	321	$11K
96110		180	179	$8K
90791		86	86	$7K
G9920	Screening performed and negative	109	109	$3K
G9012	Other specified case management service not elsewhere classified	35	24	$2K
85018		478	476	$972.44
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	26	24	$510.23
92552		28	28	$291.48
83655		49	49	$209.19
90460		25	25	$202.00
99173		28	28	$86.24
90471		1,173	1,172	$57.05
82465		57	57	$56.00
83036		15	15	$4.00
90698		68	68	$0.00
90686		214	214	$0.00
90651		85	85	$0.00
97802		17	17	$0.00
1126F		21	21	$0.00
90744		28	28	$0.00
90688		51	51	$0.00
D0120		17	17	$0.00
36415		49	49	$0.00
92081		176	176	$0.00
90472		623	622	$0.00
90633		31	31	$0.00
90670		193	193	$0.00
1160F		46	46	$0.00
90681		12	12	$0.00
90473		12	12	$0.00
99401		17	17	$0.00

Medicaid Provider Spending