CASAMALHUAPA, MARTHA

$2.52M

Total Medicaid Paid

77,643

Total Claims

72,523

Beneficiaries

62

Codes Billed

2021-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		16,088	13,254	$1.00M
99214		4,923	4,462	$420K
99392		1,859	1,857	$143K
99393		1,758	1,753	$134K
87426		3,711	3,515	$112K
87804		3,575	3,381	$95K
99391		1,251	1,215	$87K
87880		6,284	5,912	$85K
99394		851	847	$71K
99212		1,369	1,315	$46K
99058		1,684	1,559	$45K
92551		2,890	2,872	$28K
92552		884	869	$27K
96110		2,866	2,845	$25K
99000		4,620	4,306	$17K
90651		277	274	$14K
90680		735	727	$12K
99215	Prolong outpt/office vis	89	69	$11K
90633		770	765	$10K
96127		1,990	1,968	$10K
90670		667	661	$10K
90671		241	238	$10K
90677		259	258	$9K
90460		4,424	4,328	$9K
99177		2,208	2,196	$9K
90698		894	884	$8K
90744		605	597	$7K
99203		82	81	$6K
90710		155	155	$6K
99173		2,263	2,246	$5K
99383		50	50	$4K
99442		70	64	$4K
90649		134	134	$4K
94640		410	376	$4K
90686		252	251	$3K
90620		83	83	$3K
90658		302	300	$3K
90461		2,378	2,356	$3K
90716		111	111	$3K
90707		143	143	$2K
90674		159	159	$2K
90700		165	165	$2K
87807		168	157	$2K
90715		101	100	$1K
99384		14	14	$1K
99381		13	13	$1K
90648		96	96	$1K
90696		136	136	$996.93
99402		23	16	$852.60
A4617	Mouth piece	243	218	$703.50
A7015	Aerosol mask used w nebulize	412	378	$510.23
A7004	Disposable nebulizer sml vol	255	230	$436.75
94664		253	228	$85.90
J7620	Albuterol ipratrop non-comp	283	254	$55.33
S0119	Ondansetron 4 mg	32	31	$6.72
J7613	Albuterol non-comp unit	46	44	$0.10
90734		271	268	$0.00
91300		384	370	$0.00
0002A		145	145	$0.00
99404		45	33	$0.00
J7611	Albuterol non-comp con	16	15	$0.00
0001A		178	176	$0.00

Medicaid Provider Spending