AGUAS, VILMA

$14K

Total Medicaid Paid

2,832

Total Claims

2,482

Beneficiaries

6

Codes Billed

2018-01

First Month

2019-10

Last Month

Year	Claims	Total Paid
2018	1,481	$8K
2019	1,351	$6K

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	647	620	$5K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	1,192	957	$4K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	835	749	$3K
99215	Prolong outpt/office vis	70	68	$1K
90674		49	49	$399.31
G0008	Administration of influenza virus vaccine	39	39	$0.00

Medicaid Provider Spending