BORROMEO, RALPH

$33K

Total Medicaid Paid

377

Total Claims

344

Beneficiaries

4

Codes Billed

2018-01

First Month

2018-07

Last Month

Year	Claims	Total Paid
2018	377	$33K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	202	197	$19K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	146	118	$13K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	17	17	$1K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	12	12	$186.48

Medicaid Provider Spending