BRIGHAM AND WOMEN'S

$771K

Total Medicaid Paid

7,135

Total Claims

6,502

Beneficiaries

54

Codes Billed

2019-05

First Month

2020-05

Last Month

Year	Claims	Total Paid
2019	4,624	$534K
2020	2,511	$237K

Code	Description	Claims	Beneficiaries	Total Paid
G0378	Hospital observation per hr	269	137	$229K
99284		295	287	$112K
99285		144	137	$91K
99283		434	412	$90K
99211		379	357	$48K
96374		184	169	$24K
96361		121	111	$18K
80307		144	123	$17K
80048		598	518	$14K
85025		607	553	$13K
74177		41	41	$13K
71046		186	182	$12K
87635		290	252	$11K
93005		229	224	$10K
80076		380	349	$9K
96375		78	72	$8K
83735		283	252	$5K
87491		88	88	$5K
99213		32	28	$5K
87591		88	88	$5K
81025		233	228	$4K
83690		163	155	$3K
70450		13	13	$3K
86850		90	89	$3K
96365		13	13	$2K
84484		55	50	$2K
99282		13	13	$2K
81001		231	220	$2K
87086		106	103	$2K
85610		146	119	$2K
86900		104	103	$2K
86901		104	103	$2K
84702		37	32	$1K
85027		57	52	$901.55
83605		26	26	$847.47
71045		18	18	$811.44
81003		142	136	$768.50
87081		48	48	$577.87
Q9967	Locm 300-399mg/ml iodine,1ml	168	163	$545.17
84443		13	13	$514.19
88305		13	13	$472.64
80053		17	17	$409.71
85730		14	13	$203.28
84100		13	13	$184.92
87088		13	13	$166.68
J1170	Hydromorphone injection	18	14	$111.41
J3010	Fentanyl citrate injection	79	68	$95.49
J2250	Inj midazolam hydrochloride	40	39	$61.09
J1885	Ketorolac tromethamine inj	71	52	$32.40
J2001	Lidocaine injection	41	39	$28.02
J2704	Inj, propofol, 10 mg	14	12	$26.45
J2405	Ondansetron hcl injection	124	105	$25.50
J7120	Ringers lactate infusion	12	12	$8.80
U0002	Covid-19 lab test non-cdc	16	15	$0.00

Medicaid Provider Spending