D'AGATA, CAITLIN

$58K

Total Medicaid Paid

1,171

Total Claims

1,142

Beneficiaries

5

Codes Billed

2018-01

First Month

2024-07

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	640	633	$30K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	429	411	$28K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	59	59	$533.95
96110	Developmental screening, with scoring and documentation, per standardized instrument	27	27	$277.29
0502F		16	12	$0.00

Medicaid Provider Spending