Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

CDT DR MANUEL QUEVEDO BAEZ

NPI: 1811102502 · SAN JUAN, PR 00901 · State or Local Public Health Clinic/Center · NPI assigned 05/14/2007

$2K
Total Medicaid Paid
497
Total Claims
412
Beneficiaries
10
Codes Billed
2023-08
First Month
2024-09
Last Month

Provider Details

Authorized OfficialRODRIGUEZ, STEPHANIE (ADMINISTRATOR)
NPI Enumeration Date05/14/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 25 $122.67
2024 472 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 91 61 $869.80
90461 84 78 $480.00
90472 Immunization administration, each additional vaccine (list separately) 22 12 $456.76
90460 Immunization administration through 18 years of age via any route, first or only component 119 111 $372.78
90651 62 52 $0.22
90656 22 19 $0.15
90734 39 33 $0.11
90633 23 18 $0.00
90707 19 15 $0.00
90716 16 13 $0.00