1063806958

1063806958 was paid $13K by Medicaid between Apr 2018 and Sep 2018, across 1 billing code. Its largest line is G9009, Coordinated care fee, risk adjusted maintenance, level 3 — 100% of everything it billed.

33Billing provider info1063806958

33aNPI1063806958

33bProvider type—

28Total paid$13K

24GClaims38

24DCodes billed1

24AFirst – last monthApr 2018 – Sep 2018

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	38	$13K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
G9009	Coordinated care fee, risk adjusted maintenance, level 3	100%	38	38	$13K

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.