ELBAYAR, JUSTEN

$75K

Total Medicaid Paid

1,053

Total Claims

1,017

Beneficiaries

4

Codes Billed

2021-04

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	431	413	$32K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	421	404	$24K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	138	137	$15K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	63	63	$5K

Medicaid Provider Spending