BUSTOS, MARY

$9K

Total Medicaid Paid

234

Total Claims

178

Beneficiaries

4

Codes Billed

2020-11

First Month

2021-02

Last Month

Year	Claims	Total Paid
2020	88	$3K
2021	146	$6K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	77	52	$4K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	74	53	$2K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	46	36	$2K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	37	37	$887.00

Medicaid Provider Spending