CITY OF SISTERSVILLE

$2.37M

Total Medicaid Paid

41,954

Total Claims

34,698

Beneficiaries

66

Codes Billed

2018-01

First Month

2021-05

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99283		2,917	2,251	$244K
A0425	Ground mileage	689	478	$233K
80053		3,293	2,832	$195K
99284		1,436	1,082	$170K
99285		954	643	$112K
85025		3,572	3,061	$111K
36415		4,840	3,975	$105K
99282		1,421	1,202	$94K
85027		2,830	2,410	$77K
84443		1,045	977	$65K
80061		1,153	1,090	$65K
36000		1,040	862	$55K
74176		88	80	$52K
U0002	Covid-19 lab test non-cdc	610	541	$50K
71046		700	609	$50K
94761		916	732	$44K
81015		1,212	1,052	$42K
87804		605	515	$41K
93005		795	618	$40K
93041		799	668	$36K
70450		105	90	$32K
96374		730	606	$30K
83036		777	734	$30K
J7030	Normal saline solution infus	628	410	$29K
96360		584	484	$29K
87088		824	727	$28K
84484		526	393	$25K
71045		453	378	$25K
94760		364	321	$21K
83690		444	379	$19K
96365		169	110	$16K
74177		13	13	$16K
82306		153	144	$14K
81003		624	565	$13K
80048		314	275	$13K
87880		301	264	$12K
96372		424	352	$12K
94640		222	141	$10K
87070		372	306	$10K
85610		216	179	$10K
85730		198	159	$9K
87077		499	384	$9K
83605		136	102	$9K
J1885	Ketorolac tromethamine inj	203	166	$8K
87186		354	291	$8K
73630		96	65	$6K
97110		69	13	$6K
J7050	Normal saline solution infus	128	86	$6K
86140		122	105	$5K
77067		31	29	$5K
85007		113	67	$5K
96375		158	133	$4K
73610		42	34	$3K
J2405	Ondansetron hcl injection	256	213	$2K
Q0162	Ondansetron oral	37	25	$2K
93010		67	50	$2K
80305		29	24	$2K
87040		26	12	$2K
83735		60	51	$1K
82248		34	28	$886.70
J2930	Methylprednisolone injection	39	24	$835.36
82043		30	24	$723.63
84439		12	12	$619.05
81025		24	24	$556.48
86756		17	14	$507.16
87205		16	14	$211.17

Medicaid Provider Spending