O-LEE, TSUNGJU

$62K

Total Medicaid Paid

850

Total Claims

802

Beneficiaries

5

Codes Billed

2018-01

First Month

2018-12

Last Month

Year	Claims	Total Paid
2018	850	$62K

Code	Description	Claims	Beneficiaries	Total Paid
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	333	313	$27K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	414	388	$23K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	37	37	$5K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	53	52	$5K
42900		13	12	$3K

Medicaid Provider Spending