DAVIS, LANETTE

$22K

Total Medicaid Paid

357

Total Claims

306

Beneficiaries

4

Codes Billed

2024-03

First Month

2024-12

Last Month

Year	Claims	Total Paid
2024	357	$22K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	209	184	$15K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	102	82	$5K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	32	26	$3K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	14	14	$473.27

Medicaid Provider Spending