LARSON, STEPHANIE

$15K

Total Medicaid Paid

364

Total Claims

343

Beneficiaries

4

Codes Billed

2023-09

First Month

2024-10

Last Month

Year	Claims	Total Paid
2023	112	$4K
2024	252	$11K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	226	209	$9K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	111	108	$4K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	15	14	$1K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	12	12	$729.38

Medicaid Provider Spending