KILBOURNE, BARRY

$9K

Total Medicaid Paid

700

Total Claims

663

Beneficiaries

4

Codes Billed

2018-01

First Month

2018-12

Last Month

Year	Claims	Total Paid
2018	700	$9K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	403	376	$5K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	247	237	$5K
Q2037	Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)	18	18	$0.00
G0008	Administration of influenza virus vaccine	32	32	$0.00

Medicaid Provider Spending