MAITRA, SUKANTA

$16K

Total Medicaid Paid

187

Total Claims

185

Beneficiary Records

4

Codes Billed

2018-02

First Month

2018-11

Last Month

Year	Claims	Total Paid
2018	187	$16K

Code	Description	Claims	Bene. Records	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	82	80	$6K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	51	51	$5K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	27	27	$3K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	27	27	$2K

Medicaid Provider Spending