TORRES, ANNALIZA

$13K

Total Medicaid Paid

347

Total Claims

332

Beneficiary Records

5

Codes Billed

2018-10

First Month

2022-11

Last Month

Code	Description	Claims	Bene. Records	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	225	214	$8K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	58	58	$4K
Q3014	Telehealth originating site facility fee	31	27	$635.32
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	16	16	$267.20
90686		17	17	$74.42

Medicaid Provider Spending