Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OK › TAHLEQUAH › GUSTAVSON, EDWARD

GUSTAVSON, EDWARD

NPI: 1386674182 · TAHLEQUAH, OK 74464 · Developmental - Behavioral Pediatrics Physician · NPI assigned 07/04/2006

$25K
Total Medicaid Paid
175
Total Claims
174
Beneficiaries
2
Codes Billed
2019-01
First Month
2020-01
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 156 $22K
2020 19 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99215 Prolong outpt/office vis 128 127 $16K
99205 Prolong outpt/office vis 47 47 $8K