MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC.

$2.14M

Total Medicaid Paid

67,189

Total Claims

52,750

Beneficiaries

67

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99285		2,761	1,882	$533K
99284		2,070	1,478	$355K
96361		519	450	$321K
99283		951	808	$263K
G0463	Hospital outpt clinic visit	8,579	5,997	$187K
99214		5,581	3,900	$68K
87631		565	501	$44K
87636		461	408	$43K
87635		1,106	993	$38K
99213		3,324	2,301	$36K
87651		1,173	1,031	$35K
85025		6,041	4,862	$24K
84443		2,147	1,975	$22K
80053		3,103	2,654	$22K
80048		3,663	3,211	$22K
74177		65	58	$21K
80061		1,914	1,752	$19K
83036		1,994	1,862	$12K
71046		808	709	$12K
70450		36	27	$11K
C9803	Hopd covid-19 spec collect	1,392	1,249	$8K
93005		1,507	1,279	$6K
81001		2,086	1,846	$4K
85610		3,508	1,920	$4K
87880		252	245	$3K
96374		1,075	906	$3K
U0003	Cov-19 amp prb hgh thruput	83	82	$3K
86140		966	832	$3K
83735		739	622	$3K
99215	Prolong outpt/office vis	80	64	$2K
83605		222	192	$942.20
84484		124	102	$929.20
81025		142	121	$896.70
96372		441	318	$894.34
83690		208	180	$860.38
36415		4,579	3,702	$825.42
82947		223	173	$543.60
99212		56	51	$542.24
90471		42	41	$508.45
87086		140	133	$451.87
80306		40	36	$451.77
90662		125	124	$329.46
99443		18	18	$315.08
99442		22	20	$304.32
87804		30	27	$246.18
G2211	Complex e/m visit add on	65	59	$223.20
96375		348	293	$175.38
71045		59	53	$159.98
80047		35	27	$153.04
81003		91	80	$132.93
90686		85	84	$123.07
36416		723	394	$119.55
83880		13	13	$117.78
97110		251	118	$90.71
87103		14	12	$89.62
87040		28	12	$85.66
85379		14	12	$82.12
82565		13	13	$46.60
82948		23	12	$36.56
82248		12	12	$29.40
U0005	Infec agen detec ampli probe	12	12	$24.00
0764T		19	14	$16.89
85018		31	24	$15.78
J1885	Ketorolac tromethamine inj	171	150	$15.30
J7030	Normal saline solution infus	30	26	$11.01
G0008	Admin influenza virus vac	176	176	$0.00
J2405	Ondansetron hcl injection	15	12	$0.00

Medicaid Provider Spending