ESCOBAR, TONYA

$333K

Total Medicaid Paid

4,238

Total Claims

3,229

Beneficiaries

5

Codes Billed

2023-05

First Month

2024-12

Last Month

Year	Claims	Total Paid
2023	308	$27K
2024	3,930	$306K

Code	Description	Claims	Beneficiaries	Total Paid
90833	Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on)	2,068	1,521	$146K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	1,622	1,208	$143K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	229	225	$27K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	280	240	$16K
99407		39	35	$0.00

Medicaid Provider Spending