MOTTLA, JAY

$3K

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2024-06

First Month

2024-09

Last Month

Year	Claims	Total Paid
2024	53	$3K

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	12	12	$1K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	15	14	$988.50
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	14	14	$564.66
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	12	12	$498.89

Medicaid Provider Spending