ECHEVERRY-FRANCK, DIANA

$93K

Total Medicaid Paid

2,824

Total Claims

2,791

Beneficiaries

6

Codes Billed

2018-01

First Month

2021-07

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	2,421	2,389	$78K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	275	275	$11K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	40	39	$2K
99490	Ccm add 20min	45	45	$1K
76536		14	14	$357.84
G8484	Influenza immunization was not administered, reason not given	29	29	$99.00

Medicaid Provider Spending