TELEPCIAK, KATHLEEN

$6K

Total Medicaid Paid

602

Total Claims

593

Beneficiaries

6

Codes Billed

2019-12

First Month

2024-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	361	357	$3K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	40	39	$2K
96110	Developmental screening, with scoring and documentation, per standardized instrument	117	113	$1K
90460	Immunization administration through 18 years of age via any route, first or only component	59	59	$0.00
99173		13	13	$0.00
96127		12	12	$0.00

Medicaid Provider Spending