ALBUJA PONCE, ANA

$170K

Total Medicaid Paid

1,293

Total Claims

1,179

Beneficiaries

5

Codes Billed

2018-10

First Month

2022-08

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	796	706	$107K
99215	Prolong outpt/office vis	176	166	$32K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	206	196	$20K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	101	99	$8K
99222	Initial hospital care, per day, moderate complexity	14	12	$2K

Medicaid Provider Spending