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NPI 1053342485
NPI deactivated
1053342485
1053342485 was paid $374K by Medicaid between Jan 2018 and Mar 2024, across 33 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider info1053342485
33aNPI1053342485
33bProvider type—
28Total paid$374K
24GClaims11,528
24DCodes billed33
24AFirst – last monthJan 2018 – Mar 2024
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 | 4,001 | $142K | |
| 2019 | 1,665 | $53K | |
| 2020 | 878 | $23K | |
| 2021 | 751 | $20K | |
| 2022 | 1,694 | $54K | |
| 2023 | 2,362 | $81K | |
| 2024incomplete | 177 | $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% | 2,430 | 1,964 | $128K |
| 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 | 16% | 755 | 640 | $61K |
| 99401 | 10.0% | 1,425 | 1,157 | $37K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 9.5% | 1,189 | 1,074 | $35K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.6% | 218 | 212 | $21K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.1% | 163 | 155 | $15K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.7% | 145 | 131 | $14K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 3.4% | 866 | 788 | $13K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.4% | 104 | 97 | $9K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.0% | 879 | 659 | $7K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.5% | 808 | 321 | $6K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.4% | 246 | 234 | $5K |
21 more codes
| 92587 | 1.3% | 285 | $5K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 111 | $4K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 128 | $4K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 25 | $3K |
| 99058 | <1% | 122 | $2K | |
| 88740 | <1% | 775 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 74 | $1K |
| 99354 | <1% | 13 | $1K | |
| 98968 | <1% | 16 | $351.40 | |
| 96127 | <1% | 80 | $318.69 | |
| 87807 | <1% | 37 | $229.04 | |
| 90672 | 0% | 124 | $0.00 | |
| 90670 | 0% | 91 | $0.00 | |
| 90710 | 0% | 14 | $0.00 | |
| 90734 | 0% | 13 | $0.00 | |
| 90685 | 0% | 22 | $0.00 | |
| 90686 | 0% | 217 | $0.00 | |
| 90698 | 0% | 87 | $0.00 | |
| 90680 | 0% | 15 | $0.00 | |
| 90619 | 0% | 13 | $0.00 | |
| 90651 | 0% | 38 | $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.