GRUPO PEDIATRICO DE CAGUAS CSP

$389K

Total Medicaid Paid

43,992

Total Claims

38,220

Beneficiaries

35

Codes Billed

2018-01

First Month

2024-12

Last Month

Authorized Official	YSERN BORRAS, FERNANDO (PARTNER)
NPI Enumeration Date	10/17/2005

Code	Description	Claims	Beneficiaries	Total Paid
90472	Immunization administration, each additional vaccine (list separately)	5,575	4,845	$116K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	9,456	8,059	$83K
99442		2,442	2,175	$50K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	10,713	8,450	$26K
0002A		641	638	$25K
0001A		831	803	$21K
0072A		451	451	$16K
0003A		337	333	$12K
0012A		282	274	$11K
0011A		299	285	$10K
0071A		621	484	$9K
0013A		203	199	$7K
90713		1,269	1,157	$2K
91307		655	614	$480.00
90700		2,304	2,010	$420.01
90688		1,270	1,177	$411.11
90707		290	282	$406.00
90648		1,131	1,014	$204.00
90734		159	157	$177.00
90670		1,057	958	$156.00
90651		237	229	$78.00
90744		227	205	$42.00
90680		57	49	$18.00
99203	Office or other outpatient visit for the evaluation and management of a new patient, low complexity	138	137	$17.21
90685		119	106	$12.00
90716		245	241	$6.00
91301		742	703	$0.02
91300		1,796	1,748	$0.01
90686		106	106	$0.00
90677		40	40	$0.00
90715		26	26	$0.00
90633		161	155	$0.00
90687		72	70	$0.00
90671		15	15	$0.00
90681		25	25	$0.00

Medicaid Provider Spending