FAMILY AND INTERNAL MEDICINE OF DIXWELL AVENUE

$2.51M

Total Medicaid Paid

79,533

Total Claims

66,973

Beneficiaries

50

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		36,184	29,187	$1.65M
99214		9,950	8,597	$497K
99396		737	698	$78K
93000		6,743	5,944	$69K
99203		617	546	$49K
99490	Ccm add 20min	3,753	3,733	$43K
96127		2,217	2,046	$33K
99395		235	228	$25K
96372		2,968	1,936	$22K
90674		444	404	$7K
99442		295	264	$7K
87811		214	189	$4K
99491	Ccm add 20min	193	193	$3K
J3420	Vitamin b12 injection	2,941	1,921	$3K
90756		190	137	$3K
G0179	Md recertification hha pt	266	263	$2K
94640		455	409	$2K
G0506	Comp asses care plan ccm svc	247	242	$2K
99497		144	132	$711.44
90688		59	55	$695.76
87804		86	41	$636.84
G0180	Md certification hha patient	50	49	$470.64
99397		64	63	$419.61
99495		12	12	$401.85
90694		80	78	$358.40
99487	Ccm add 20min	12	12	$149.56
82272		50	50	$102.63
86580		12	12	$75.12
90662		18	17	$49.03
81002		2,678	2,381	$47.12
90471		223	207	$43.67
G0439	Ppps, subseq visit	176	172	$0.01
1125F		1,327	1,196	$0.00
1126F		2,093	1,955	$0.00
3017F		334	324	$0.00
1170F		528	488	$0.00
G8754	Dias bp less 90	443	430	$0.00
3008F		376	345	$0.00
3044F		80	77	$0.00
1111F		12	12	$0.00
G0008	Admin influenza virus vac	206	202	$0.00
G8510	Scr dep neg, no plan reqd	13	13	$0.00
G0444	Depression screen annual	242	223	$0.00
1159F		529	500	$0.00
1158F		52	47	$0.00
1160F		530	501	$0.00
G8752	Sys bp less 140	402	390	$0.00
90653		20	20	$0.00
3045F		20	19	$0.00
G9899	Scrn mam perf rslts doc	13	13	$0.00

Medicaid Provider Spending