GRAMBART, SEAN

$9K

Total Medicaid Paid

340

Total Claims

322

Beneficiaries

4

Codes Billed

2018-01

First Month

2019-06

Last Month

Year	Claims	Total Paid
2018	234	$6K
2019	106	$3K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	225	211	$5K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	60	56	$2K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	43	43	$1K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	12	12	$421.88

Medicaid Provider Spending