WHITE SANDS FAMILY PRACTICE CLINIC, INC.

$971K

Total Medicaid Paid

28,622

Total Claims

22,736

Beneficiaries

38

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99215	Prolong outpt/office vis	3,876	2,701	$417K
99214		3,238	2,618	$252K
95250		1,057	883	$115K
99213		1,821	1,518	$85K
95251		2,003	1,711	$45K
80305		1,532	1,097	$17K
99205	Prolong outpt/office vis	90	87	$17K
99203		101	99	$8K
36415		572	554	$4K
83036		478	441	$3K
82962		1,319	1,029	$3K
99202		35	33	$2K
82948		374	270	$1K
99000		13	13	$70.16
G8427	Docrev cur meds by elig clin	2,424	1,910	$0.00
G8752	Sys bp less 140	1,904	1,527	$0.00
G8421	Bmi not calculated	47	41	$0.00
G8753	Sys bp > or = 140	432	371	$0.00
G8417	Calc bmi abv up param f/u	1,689	1,341	$0.00
G9905	No pt tbco scrn rng	92	68	$0.00
3078F		118	94	$0.00
3046F		304	255	$0.00
3077F		34	31	$0.00
G8428	Cur meds not document	130	111	$0.00
G8754	Dias bp less 90	2,046	1,615	$0.00
G9903	Pt scrn tbco id as non user	1,725	1,326	$0.00
3044F		260	236	$0.00
G8419	Calc bmi out nrm param nof/u	83	67	$0.00
G8420	Calc bmi norm parameters	66	51	$0.00
G8405	Low extemity neur not perfor	218	176	$0.00
G8755	Dias bp > or = 90	181	162	$0.00
3074F		111	90	$0.00
1036F		84	71	$0.00
3075F		13	12	$0.00
3079F		19	18	$0.00
G9902	Pt scrn tbco and id as user	99	77	$0.00
G8430	Doc med rsn no medrec	21	19	$0.00
3080F		13	13	$0.00

Medicaid Provider Spending