MOORE, DAVID

$9K

Total Medicaid Paid

128

Total Claims

125

Beneficiaries

5

Codes Billed

2020-01

First Month

2022-11

Last Month

Year	Claims	Total Paid
2020	31	$2K
2022	97	$7K

Code	Description	Claims	Beneficiaries	Total Paid
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	37	36	$4K
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	43	42	$3K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	18	18	$1K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	13	13	$741.52
87400		17	16	$149.94

Medicaid Provider Spending