MOBERLY HOSPITAL COMPANY LLC

$8.61M

Total Medicaid Paid

56,982

Total Claims

49,607

Beneficiaries

52

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
X4011		4,403	3,932	$2.48M
99283		9,915	9,283	$1.90M
85025		8,973	7,784	$905K
99284		3,535	3,174	$766K
80053		7,710	6,675	$757K
81003		3,606	3,194	$571K
93005		2,162	1,779	$241K
87804		2,463	1,866	$225K
71046		314	287	$82K
85027		387	298	$81K
87880		883	857	$78K
96374		333	308	$61K
X4006		42	27	$59K
84484		934	738	$58K
87081		1,317	1,220	$44K
71045		690	583	$41K
99281		538	505	$32K
85610		415	332	$31K
83690		225	204	$25K
99285		169	143	$24K
87426		1,822	1,638	$23K
G0378	Hospital observation per hr	54	38	$22K
83880		137	122	$14K
93306		79	63	$12K
99282		166	163	$12K
81025		12	12	$9K
87086		15	13	$8K
96361		157	144	$6K
81001		16	15	$6K
88305		136	96	$6K
96372		97	95	$5K
0000000		162	92	$4K
C9803	Hopd covid-19 spec collect	1,115	993	$4K
80307		16	12	$3K
U0003	Cov-19 amp prb hgh thruput	302	275	$3K
97110		51	12	$3K
83735		626	548	$2K
96375		36	35	$1K
J3490	Drugs unclassified injection	1,950	1,195	$1K
84443		79	73	$1K
G0463	Hospital outpt clinic visit	12	12	$900.92
87807		54	53	$731.66
96365		15	12	$612.60
70450		17	12	$606.03
85730		85	69	$267.31
80048		58	56	$229.48
83036		13	12	$70.96
80076		12	12	$29.40
36415		531	421	$25.88
80061		12	12	$21.42
82962		25	13	$7.70
Q9967	Locm 300-399mg/ml iodine,1ml	106	100	$0.00

Medicaid Provider Spending