MATA-MACHADO, NIKOLAS

$79K

Total Medicaid Paid

1,377

Total Claims

1,262

Beneficiaries

6

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	786	714	$55K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	454	423	$16K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	96	86	$5K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	13	13	$1K
99215	Prolong outpt/office vis	14	14	$946.93
95812		14	12	$874.49

Medicaid Provider Spending