KOFLER, LUIZA

$16K

Total Medicaid Paid

212

Total Claims

190

Beneficiaries

5

Codes Billed

2022-02

First Month

2024-12

Last Month

Year	Claims	Total Paid
2022	13	$543.54
2024	199	$15K

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	80	78	$7K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	34	30	$3K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	47	38	$3K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	38	31	$2K
0072A		13	13	$543.54

Medicaid Provider Spending