DUNLEAVY, MARYKATE

$10K

Total Medicaid Paid

204

Total Claims

168

Beneficiaries

5

Codes Billed

2018-03

First Month

2018-11

Last Month

Year	Claims	Total Paid
2018	204	$10K

Code	Description	Claims	Beneficiaries	Total Paid
99283	Emergency department visit for the evaluation and management, moderate severity	121	92	$5K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	25	21	$2K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	33	31	$2K
99284	Emergency department visit for the evaluation and management, high severity	12	12	$811.50
81003		13	12	$19.00

Medicaid Provider Spending