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NPI 1043397797
NPI deactivated
1043397797
1043397797 was paid $393K by Medicaid between Jan 2018 and Jan 2019, across 38 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider info1043397797
33aNPI1043397797
33bProvider type—
28Total paid$393K
24GClaims9,132
24DCodes billed38
24AFirst – last monthJan 2018 – Jan 2019
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 9,116 | $392K | |
| 2019 | 16 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 34% | 2,030 | 1,879 | $134K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 12% | 499 | 486 | $47K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 11% | 452 | 433 | $42K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 811 | 788 | $40K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 9.9% | 398 | 387 | $39K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.6% | 222 | 221 | $22K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.3% | 180 | 175 | $17K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.2% | 115 | 113 | $13K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.1% | 70 | 70 | $8K |
| 76140 | 1.6% | 104 | 103 | $6K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.4% | 555 | 302 | $6K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.2% | 519 | 504 | $5K |
26 more codes
| 99050 | <1% | 218 | $3K | |
| 99383 | <1% | 31 | $3K | |
| 94760 | <1% | 1,102 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 98 | $2K |
| 99382 | <1% | 16 | $2K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 104 | $2K |
| 99188 | <1% | 75 | $901.59 | |
| 94664 | <1% | 104 | $739.10 | |
| 81002 | <1% | 78 | $165.66 | |
| J7645 | Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram | <1% | 28 | $111.60 |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 105 | $100.29 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 92 | $18.70 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 49 | $11.30 |
| 90680 | 0% | 47 | $0.00 | |
| 90647 | 0% | 52 | $0.00 | |
| 90698 | 0% | 88 | $0.00 | |
| 90686 | 0% | 91 | $0.00 | |
| 90696 | 0% | 30 | $0.00 | |
| 90733 | 0% | 40 | $0.00 | |
| 90651 | 0% | 79 | $0.00 | |
| 90723 | 0% | 12 | $0.00 | |
| 90744 | 0% | 73 | $0.00 | |
| 90633 | 0% | 154 | $0.00 | |
| 90670 | 0% | 225 | $0.00 | |
| 90710 | 0% | 134 | $0.00 | |
| 90715 | 0% | 52 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.