HUMPHREY, NICOLE

$74K

Total Medicaid Paid

1,478

Total Claims

1,227

Beneficiaries

4

Codes Billed

2020-01

First Month

2023-06

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	565	442	$34K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	649	573	$26K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	123	114	$9K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	141	98	$6K

Medicaid Provider Spending