DAVIS, KELLY

$31K

Total Medicaid Paid

502

Total Claims

446

Beneficiaries

Codes Billed

2024-04

First Month

2024-12

Last Month

Year	Claims	Total Paid
2024	502	$31K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	194	167	$11K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	175	159	$10K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	85	78	$7K
17110		36	30	$2K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	12	12	$1K

Medicaid Provider Spending