KETNER, KISHIMJAN

$9K

Total Medicaid Paid

551

Total Claims

509

Beneficiaries

5

Codes Billed

2022-11

First Month

2024-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	83	75	$5K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	22	19	$2K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	14	13	$955.50
99441		101	100	$773.72
36415	Collection of venous blood by venipuncture	331	302	$612.87

Medicaid Provider Spending