C. DICOVSKY MEDICAL GROUP, LLC

$1.51M

Total Medicaid Paid

77,132

Total Claims

64,758

Beneficiaries

63

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		16,520	14,462	$665K
99214		2,236	2,022	$124K
93306		1,661	995	$86K
96372		7,598	6,060	$77K
99441		3,476	2,993	$75K
G0439	Ppps, subseq visit	1,466	1,325	$73K
99212		1,948	1,711	$53K
99442		1,450	1,274	$52K
71046		4,255	3,825	$46K
99443		939	819	$42K
76770		996	834	$40K
93880		976	778	$32K
99211		2,294	2,036	$24K
93000		3,079	2,836	$23K
76700		586	508	$22K
99204		86	81	$9K
76856		157	143	$7K
G0008	Admin influenza virus vac	936	850	$6K
G0444	Depression screen annual	563	455	$6K
J1885	Ketorolac tromethamine inj	3,843	3,117	$5K
93015		112	100	$5K
J1030	Methylprednisolone 40 mg inj	964	865	$5K
90688		755	665	$4K
82270		2,070	752	$4K
82962		4,760	4,197	$3K
76536		73	67	$3K
99396		30	27	$3K
77081		414	266	$3K
J1100	Dexamethasone sodium phos	3,009	2,488	$2K
Q0091	Obtaining screen pap smear	207	181	$2K
J3420	Vitamin b12 injection	1,639	1,216	$2K
90686		196	195	$2K
93224		28	28	$1K
G0101	Ca screen;pelvic/breast exam	194	146	$1K
90732		27	26	$1K
82948		504	406	$991.66
99397		36	31	$920.80
36415		307	278	$564.79
36416		1,484	1,111	$453.83
88150		128	103	$376.56
93018		47	39	$306.21
93040		27	27	$153.02
90471		15	12	$148.60
3078F		812	703	$128.03
Q2037	Fluvirin vacc, 3 yrs & >, im	13	13	$123.49
92250		21	13	$112.98
3074F		544	483	$93.02
1170F		765	667	$72.03
J3360	Diazepam injection	12	12	$49.69
G0009	Admin pneumococcal vaccine	15	12	$46.16
99406		14	12	$41.22
99000		444	368	$30.83
1157F		482	430	$28.01
1159F		271	226	$23.01
1126F		293	257	$21.01
1160F		301	271	$17.00
94760		17	15	$13.14
1125F		141	119	$11.02
3008F		725	650	$10.00
1158F		37	35	$0.07
3044F		27	24	$0.00
99072		82	77	$0.00
1124F		25	21	$0.00

Medicaid Provider Spending