DE GUZMAN, ROSALIE

$370K

Total Medicaid Paid

66,759

Total Claims

65,142

Beneficiaries

69

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		14,977	13,838	$94K
99391		1,673	1,638	$69K
99381		607	581	$59K
92551		5,761	5,724	$52K
99392		2,549	2,524	$14K
G9920	Scrning perf and negative	5,471	5,458	$14K
90670		1,680	1,667	$11K
90700		1,829	1,815	$8K
90648		1,747	1,729	$8K
99393		2,077	2,063	$6K
90713		1,205	1,195	$5K
90686		2,510	2,493	$4K
90681		496	494	$3K
99394		1,629	1,613	$3K
90677		335	335	$3K
90651		624	613	$3K
90744		909	904	$3K
99203		18	13	$2K
90633		1,022	1,019	$2K
99214		92	87	$1K
90716		808	806	$872.37
99211		591	588	$784.65
87430		92	91	$745.20
90707		811	809	$647.37
90680		73	72	$630.00
90685		44	34	$394.73
99395		185	185	$259.80
90698		26	26	$234.00
94640		80	75	$202.08
G2012	Brief check in by md/qhp	682	646	$169.29
90688		15	15	$135.00
90619		446	446	$80.64
96110		1,115	1,113	$72.57
90620		368	368	$62.91
90715		59	56	$62.82
96156		2,430	2,417	$39.90
90696		130	130	$35.91
85018		972	961	$28.78
81000		845	835	$27.84
90734		33	33	$27.00
G0442	Annual alcohol screen 15 min	140	140	$24.75
99173		1,294	1,284	$8.66
86580		63	62	$7.32
G8510	Scr dep neg, no plan reqd	1,284	1,283	$3.98
J7613	Albuterol non-comp unit	39	37	$1.56
84443		697	686	$0.00
85025		797	788	$0.00
83036		53	53	$0.00
36415		923	909	$0.00
80053		688	680	$0.00
3351F		79	79	$0.00
82306		91	90	$0.00
3352F		59	59	$0.00
90471		37	26	$0.00
87086		112	105	$0.00
1220F		150	150	$0.00
87591		28	28	$0.00
90460		515	507	$0.00
90672		170	170	$0.00
83655		68	68	$0.00
87880		29	29	$0.00
81003		619	613	$0.00
87491		225	221	$0.00
G8431	Pos clin depres scrn f/u doc	141	141	$0.00
84439		683	673	$0.00
90621		35	35	$0.00
80061		694	687	$0.00
96160		17	17	$0.00
83525		13	13	$0.00

Medicaid Provider Spending