ALICIA GUSTAFSON, D.O.
Sports Medicine (Internal Medicine) Physician · BLOOMINGTON, MN
Individual Active NPI 1417210790
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 138 | 342 | $86,037 | $26,308 | $18,527 |
| 2023 | 67 | 316 | $68,987 | $24,835 | $18,216 |
| 2022 | 44 | 160 | $38,833 | $14,574 | $10,054 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 71 | $124 | $75 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 48 | $1 | $1 |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 48 | $86 | $54 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 35 | $15 | $7 |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 33 | $106 | $80 |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 20 | $161 | $115 |
| 20610 | Aspiration and/or injection of fluid from large joint | 16 | $64 | $51 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 15 | $123 | $123 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | ✓ | 75542 | MN |
| Family Medicine Physician | 207Q00000X | S9140 | TX | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | S9140 | TX |
Medicare eligibility
- Part B
- Yes
- DME
- Yes
- Home health
- Yes
- Power mobility
- Yes
- Hospice
- Yes
Other Sports Medicine (Internal Medicine) Physician providers in Minnesota
- NPI 1720030752
- NPI 1174939706
- NPI 1366671406
See all Sports Medicine (Internal Medicine) Physician providers in Minnesota →
Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.