COULIBALY, SURURAT

$81K

Total Medicaid Paid

1,419

Total Claims

1,353

Beneficiaries

5

Codes Billed

2018-01

First Month

2019-01

Last Month

Year	Claims	Total Paid
2018	1,400	$81K
2019	19	$812.24

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	883	834	$45K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	287	282	$21K
17110		179	170	$11K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	41	38	$3K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	29	29	$2K

Medicaid Provider Spending