CODMAN SQUARE HEALTH CENTER, INC

$8.55M

Total Medicaid Paid

127,578

Total Claims

122,808

Beneficiaries

46

Codes Billed

2018-09

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		56,269	53,563	$5.03M
99214		24,221	23,410	$2.56M
U0003	Cov-19 amp prb hgh thruput	1,801	1,731	$135K
99203		803	800	$118K
99050		6,339	6,220	$96K
99211		994	913	$94K
87591		2,464	2,384	$74K
87491		2,438	2,358	$73K
94640		1,017	959	$57K
U0005	Infec agen detec ampli probe	1,799	1,729	$45K
G2023	Specimen collect covid-19	1,849	1,778	$43K
99215	Prolong outpt/office vis	357	355	$41K
99212		201	200	$26K
87880		2,023	2,002	$25K
81025		2,492	2,412	$16K
99204		377	377	$16K
87210		3,312	3,181	$15K
87220		3,273	3,145	$13K
87389		507	504	$11K
99051		2,514	2,497	$10K
86485		327	323	$8K
85025		879	874	$7K
80053		629	625	$6K
J1885	Ketorolac tromethamine inj	1,487	1,455	$6K
81003		2,591	2,535	$5K
86780		376	375	$5K
96372		2,299	2,247	$3K
90658		106	106	$3K
81001		943	931	$3K
86803		211	211	$3K
82962		1,025	981	$3K
T1015	Clinic service	235	235	$1K
84443		77	77	$1K
82948		239	233	$1K
J7620	Albuterol ipratrop non-comp	552	534	$587.54
83036		63	63	$560.55
J0696	Ceftriaxone sodium injection	162	158	$364.93
90460		12	12	$84.74
80048		12	12	$81.69
J8499	Oral prescrip drug non chemo	26	26	$1.98
A9150	Misc/exper non-prescript dru	123	123	$0.00
90471		29	29	$0.00
J7613	Albuterol non-comp unit	13	13	$0.00
J7512	Prednisone ir or dr oral 1mg	12	12	$0.00
71046		87	87	$0.00
S0119	Ondansetron 4 mg	13	13	$0.00

Medicaid Provider Spending