MUPOMBWA, TARIRO

$13K

Total Medicaid Paid

358

Total Claims

330

Beneficiaries

4

Codes Billed

2021-07

First Month

2024-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	269	243	$9K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	38	37	$3K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	38	37	$1K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	13	13	$357.42

Medicaid Provider Spending