STACKPOLE, SARAH

$56K

Total Medicaid Paid

935

Total Claims

917

Beneficiaries

6

Codes Billed

2023-06

First Month

2024-11

Last Month

Year	Claims	Total Paid
2023	320	$19K
2024	615	$37K

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	189	189	$17K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	273	272	$16K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	268	257	$12K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	165	159	$10K
99443		28	28	$1K
99442		12	12	$137.27

Medicaid Provider Spending