WARD, TAMMY

$9K

Total Medicaid Paid

184

Total Claims

181

Beneficiaries

5

Codes Billed

2019-07

First Month

2020-11

Last Month

Year	Claims	Total Paid
2019	157	$9K
2020	27	$377.48

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	100	97	$5K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	28	28	$2K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	16	16	$1K
90460	Immunization administration through 18 years of age via any route, first or only component	26	26	$333.06
90461		14	14	$196.51

Medicaid Provider Spending