MANTICA, ABIGAIL

$6K

Total Medicaid Paid

156

Total Claims

152

Beneficiaries

6

Codes Billed

2018-12

First Month

2023-07

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	56	56	$2K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	15	15	$1K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	43	41	$828.30
72082		16	16	$672.51
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	14	12	$402.62
72170		12	12	$170.71

Medicaid Provider Spending