PAN, HARRY

$98K

Total Medicaid Paid

1,074

Total Claims

965

Beneficiaries

Codes Billed

2018-01

First Month

2018-12

Last Month

Year	Claims	Total Paid
2018	1,074	$98K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	747	652	$64K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	154	147	$20K
G0438	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	142	136	$13K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	31	30	$2K

Medicaid Provider Spending