BUSTAMANTE, MARIA

$2K

Total Medicaid Paid

294

Total Claims

231

Beneficiaries

6

Codes Billed

2022-06

First Month

2022-09

Last Month

Year	Claims	Total Paid
2022	294	$2K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	61	50	$1K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	31	23	$677.13
81002		22	15	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	63	50	$0.00
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	96	80	$0.00
99000		21	13	$0.00

Medicaid Provider Spending