LAPASARAN, ALEX

$107K

Total Medicaid Paid

1,037

Total Claims

1,027

Beneficiaries

5

Codes Billed

2018-01

First Month

2018-12

Last Month

Year	Claims	Total Paid
2018	1,037	$107K

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	517	512	$64K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	463	459	$38K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	27	27	$2K
99205	Prolong outpt/office vis	14	14	$2K
99215	Prolong outpt/office vis	16	15	$2K

Medicaid Provider Spending