PROMISSON, CARLEY

$9K

Total Medicaid Paid

223

Total Claims

209

Beneficiaries

3

Codes Billed

2024-06

First Month

2024-11

Last Month

Year	Claims	Total Paid
2024	223	$9K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	164	151	$8K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	29	29	$439.60
G8483	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	30	29	$0.00

Medicaid Provider Spending