LOAR, RICKI

$110K

Total Medicaid Paid

1,888

Total Claims

1,583

Beneficiaries

6

Codes Billed

2019-10

First Month

2021-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	482	391	$35K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	640	546	$29K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	307	242	$21K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	327	288	$14K
99205	Prolong outpt/office vis	111	101	$11K
91200		21	15	$170.90

Medicaid Provider Spending