LOPEZ, ULISES · NPI 1831289982 · Medicaid Spending

$65K

Total Medicaid Paid

1,205

Total Claims

1,058

Beneficiaries

Codes Billed

2018-01

First Month

2024-10

Last Month

Monthly Spending Trend

Yearly Breakdown

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	1,055	919	$59K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	48	43	$3K
99070		60	58	$2K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	12	12	$530.90
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	30	26	$488.08