AL-JARRAH, MOHAMAD

$12K

Total Medicaid Paid

354

Total Claims

350

Beneficiaries

5

Codes Billed

2023-03

First Month

2023-05

Last Month

Year	Claims	Total Paid
2023	354	$12K

Code	Description	Claims	Beneficiaries	Total Paid
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	67	67	$4K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	56	54	$4K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	71	71	$4K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	33	33	$273.80
99051		127	125	$50.00

Medicaid Provider Spending