1083026405

1083026405 was paid $4.33M by Medicaid between Jan 2018 and Jun 2023, across 2 billing codes. Its largest line is G9002, Coordinated care fee, maintenance rate — 86% of everything it billed.

33Billing provider info1083026405

33aNPI1083026405

33bProvider type—

28Total paid$4.33M

24GClaims13,544

24DCodes billed2

24AFirst – last monthJan 2018 – Jun 2023

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	2,140	$684K
2019	2,505	$801K
2020	2,729	$873K
2021	2,780	$887K
2022	1,926	$616K
2023	1,464	$468K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
G9002	Coordinated care fee, maintenance rate	86%	11,634	11,618	$3.72M
T2024	Service assessment/plan of care development, waiver	14%	1,910	1,910	$608K

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.