JERADEH BOURSOULIAN, LANA

$110K

Total Medicaid Paid

742

Total Claims

709

Beneficiaries

5

Codes Billed

2018-01

First Month

2020-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
95810	Polysomnography; sleep staging with 4 or more additional parameters	289	279	$52K
95782		291	281	$40K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	94	85	$13K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	54	52	$3K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	14	12	$1K

Medicaid Provider Spending