Physician
Gustavson, Edward
Gustavson, Edward was paid $25K by Medicaid between Jan 2019 and Jan 2020, across 2 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 66% of everything it billed.
33Billing provider infoGUSTAVSON, EDWARD
TAHLEQUAH, OK 74464
TAHLEQUAH, OK 74464
33aNPI1386674182assigned 07/04/2006
33bProvider typeDevelopmental - Behavioral Pediatrics Physician
28Total paid$25K
24GClaims175
24DCodes billed2
24AFirst – last monthJan 2019 – Jan 2020
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 156 | $22K | |
| 2020 | 19 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 66% | 128 | 127 | $16K |
| 99205 | Prolong outpt/office vis | 34% | 47 | 47 | $8K |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.