TACK, SHEILA

$19K

Total Medicaid Paid

571

Total Claims

556

Beneficiaries

5

Codes Billed

2018-01

First Month

2018-11

Last Month

Year	Claims	Total Paid
2018	571	$19K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	209	204	$10K
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	173	169	$6K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	151	147	$3K
81025		26	24	$168.45
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	12	12	$98.82

Medicaid Provider Spending