DIBARTOLA, ALEX

$27K

Total Medicaid Paid

742

Total Claims

692

Beneficiaries

4

Codes Billed

2023-09

First Month

2024-07

Last Month

Year	Claims	Total Paid
2023	300	$11K
2024	442	$16K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	307	272	$9K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	259	255	$9K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	117	114	$6K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	59	51	$2K

Medicaid Provider Spending