1063515831

1063515831 was paid $1K by Medicaid between Jan 2018 and Nov 2020, across 4 billing codes. Its largest line is 90471, Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine — 73% of everything it billed.

33Billing provider info1063515831

33aNPI1063515831

33bProvider type—

28Total paid$1K

24GClaims209

24DCodes billed4

24AFirst – last monthJan 2018 – Nov 2020

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	75	$0.00
2020	134	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	73%	77	59	$731.50
90686		27%	43	29	$276.67
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	0%	75	73	$0.00
90471CG		0%	14	14	$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.