1083688428

1083688428 was paid $21K by Medicaid between Jan 2018 and Apr 2018, across 14 billing codes. Its largest line is 80307, Drug test(s), presumptive, any number of drug classes; immunoassay — 29% of everything it billed.

33Billing provider info1083688428

33aNPI1083688428

33bProvider type—

28Total paid$21K

24GClaims1,596

24DCodes billed14

24AFirst – last monthJan 2018 – Apr 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	1,596	$21K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	29%	167	131	$6K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed	28%	121	80	$6K
84443	Thyroid stimulating hormone (TSH)	12%	242	215	$2K
80053	Comprehensive metabolic panel	10%	346	308	$2K
80061	Lipid panel	5.4%	131	111	$1K
82607		3.1%	51	48	$635.87
82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	2.7%	81	71	$562.04
84439		2.2%	75	68	$443.74
80171		1.9%	42	35	$400.06
83735		1.9%	98	89	$398.25
82550		1.7%	92	87	$341.90
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	98	90	$143.77

2 more codes

80048	Basic metabolic panel (calcium, ionized)	<1%	37	$113.44
83036	Hemoglobin; glycosylated (A1C)	<1%	15	$65.14

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.