DIETERICH, JAMES

$22K

Total Medicaid Paid

381

Total Claims

325

Beneficiary Records

4

Codes Billed

2023-10

First Month

2024-10

Last Month

Year	Claims	Total Paid
2023	42	$3K
2024	339	$19K

Code	Description	Claims	Bene. Records	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	141	116	$8K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	106	101	$7K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	85	68	$4K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	49	40	$2K

Medicaid Provider Spending