SZCZUPAK, MIKHAYLO

$8K

Total Medicaid Paid

134

Total Claims

133

Beneficiaries

6

Codes Billed

2021-09

First Month

2023-01

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	29	28	$3K
31231		26	26	$2K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	27	27	$2K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	27	27	$1K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	13	13	$447.66
69210		12	12	$220.00

Medicaid Provider Spending