LOPEZ, BENIGNO

$1.27M

Total Medicaid Paid

39,847

Total Claims

15,788

Beneficiaries

22

Codes Billed

2018-01

First Month

2024-12

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	6,013	5,138	$513K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	6,694	4,909	$331K
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	7,113	1,022	$133K
97032		7,113	1,022	$91K
97035		7,113	1,022	$91K
29515		424	341	$23K
29425		415	341	$22K
97010		3,200	518	$20K
29075		164	149	$9K
Q4037	Cast supplies, short leg cast, adult (11 years +), plaster	329	279	$8K
Q4045	Cast supplies, short leg splint, adult (11 years +), plaster	353	280	$7K
29505		161	129	$6K
73610		141	119	$4K
73562		124	114	$4K
73130		104	83	$3K
29125		48	39	$2K
Q4009	Cast supplies, short arm cast, adult (11 years +), plaster	146	130	$2K
73630		57	50	$1K
Q4041	Cast supplies, long leg splint, adult (11 years +), plaster	45	39	$1K
Q4021	Cast supplies, short arm splint, adult (11 years +), plaster	29	24	$555.00
Q4038	Cast supplies, short leg cast, adult (11 years +), fiberglass	46	27	$315.00
73110		15	13	$135.55

Medicaid Provider Spending