FAISON, ALPHONZA

$56K

Total Medicaid Paid

809

Total Claims

571

Beneficiaries

5

Codes Billed

2020-01

First Month

2022-08

Last Month

Year	Claims	Total Paid
2020	757	$54K
2022	52	$2K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	311	214	$26K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	335	221	$17K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	99	84	$9K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	50	39	$3K
99215	Prolong outpt/office vis	14	13	$1K

Medicaid Provider Spending