TAN, ANTONIO

$27K

Total Medicaid Paid

9,508

Total Claims

9,221

Beneficiaries

47

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99348		712	712	$7K
99336		186	186	$6K
99214		1,730	1,712	$5K
90686		200	198	$3K
90688		104	103	$2K
G2211	Complex e/m visit add on	139	137	$1K
99213		459	418	$919.86
G0008	Admin influenza virus vac	62	62	$816.96
86580		146	146	$153.00
99205	Prolong outpt/office vis	13	13	$82.70
G9920	Scrning perf and negative	187	181	$57.42
99215	Prolong outpt/office vis	119	118	$56.63
90471		34	34	$53.04
G0444	Depression screen annual	47	47	$20.20
G0439	Ppps, subseq visit	26	26	$2.73
84443		215	211	$0.00
3008F		481	473	$0.00
85025		354	345	$0.00
G0499	Hepb screen high risk indiv	234	232	$0.00
3074F		380	378	$0.00
87661		111	109	$0.00
82607		29	29	$0.00
G0443	Brief alcohol misuse counsel	162	160	$0.00
G8510	Scr dep neg, no plan reqd	305	302	$0.00
80053		317	313	$0.00
87492		123	123	$0.00
83036		80	79	$0.00
H0049	Alcohol/drug screening	64	63	$0.00
82306		216	214	$0.00
3079F		50	49	$0.00
82746		29	29	$0.00
81001		197	195	$0.00
36415		370	356	$0.00
96156		72	69	$0.00
86780		123	123	$0.00
3351F		13	13	$0.00
87389		317	167	$0.00
1111F		13	13	$0.00
3075F		12	12	$0.00
82043		31	31	$0.00
99499		145	144	$0.00
3078F		319	316	$0.00
87530		123	123	$0.00
80061		246	245	$0.00
87592		123	123	$0.00
G9919	Scrn nd pos nd prov of rec	73	73	$0.00
81003		17	16	$0.00

Medicaid Provider Spending