CLUETT, JAYNE

$203K

Total Medicaid Paid

2,838

Total Claims

2,222

Beneficiaries

5

Codes Billed

2018-01

First Month

2022-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	1,417	1,198	$123K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1,097	876	$58K
59025	Fetal non-stress test	269	98	$17K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	43	38	$2K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	12	12	$2K

Medicaid Provider Spending