ELLOWAY, SIMON

$37K

Total Medicaid Paid

1,308

Total Claims

1,160

Beneficiaries

5

Codes Billed

2018-01

First Month

2020-07

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	819	714	$27K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	176	160	$8K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	58	55	$1K
36415	Collection of venous blood by venipuncture	86	81	$156.49
94760		169	150	$126.58

Medicaid Provider Spending