TRACY, JAMES

$49K

Total Medicaid Paid

861

Total Claims

439

Beneficiaries

6

Codes Billed

2018-01

First Month

2019-01

Last Month

Year	Claims	Total Paid
2018	846	$49K
2019	15	$178.39

Code	Description	Claims	Beneficiaries	Total Paid
95004	Percutaneous tests with allergenic extracts, immediate type reaction	106	85	$17K
95024		59	55	$12K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	53	40	$7K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	63	55	$7K
95117		567	191	$5K
95165	Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials	13	13	$2K

Medicaid Provider Spending