STOCKWELL, ERICA

$3K

Total Medicaid Paid

264

Total Claims

198

Beneficiaries

6

Codes Billed

2018-03

First Month

2018-08

Last Month

Year	Claims	Total Paid
2018	264	$3K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	19	18	$2K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	13	13	$736.52
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	12	12	$399.49
59025	Fetal non-stress test	17	16	$328.67
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	12	12	$238.83
0502F		191	127	$0.00

Medicaid Provider Spending