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NPI 1093814907
NPI deactivated
1093814907
1093814907 was paid $4K by Medicaid between Jan 2018 and Oct 2019, across 51 billing codes. Its largest line is 90658, — 91% of everything it billed.
33Billing provider info1093814907
33aNPI1093814907
33bProvider type—
28Total paid$4K
24GClaims26,143
24DCodes billed51
24AFirst – last monthJan 2018 – Oct 2019
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 | 12,476 | $3K | |
| 2019 | 13,667 | $199.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90658 | 91% | 424 | 421 | $3K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.3% | 10,636 | 9,770 | $188.00 |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 2.2% | 78 | 78 | $79.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,248 | 1,238 | $30.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 187 | 187 | $15.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 34 | 33 | $0.00 |
| 3077F | 0% | 778 | 753 | $0.00 | |
| 3078F | 0% | 843 | 825 | $0.00 | |
| 3015F | 0% | 336 | 330 | $0.00 | |
| 1158F | 0% | 1,093 | 1,073 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 59 | 59 | $0.00 |
| 92081 | 0% | 1,086 | 1,085 | $0.00 |
39 more codes
| 99401 | 0% | 95 | $0.00 | |
| 90791 | Psychiatric diagnostic evaluation | 0% | 793 | $0.00 |
| 81025 | 0% | 294 | $0.00 | |
| 0502F | 0% | 92 | $0.00 | |
| 2022F | 0% | 29 | $0.00 | |
| 82948 | 0% | 173 | $0.00 | |
| 2024F | 0% | 60 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 42 | $0.00 |
| 99408 | 0% | 42 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 13 | $0.00 |
| 2028F | 0% | 29 | $0.00 | |
| 90715 | 0% | 16 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 25 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 40 | $0.00 |
| 90633 | 0% | 13 | $0.00 | |
| 3074F | 0% | 491 | $0.00 | |
| 85018 | 0% | 827 | $0.00 | |
| 82962 | 0% | 329 | $0.00 | |
| 3351F | 0% | 1,792 | $0.00 | |
| 3075F | 0% | 301 | $0.00 | |
| 3014F | 0% | 140 | $0.00 | |
| 90657 | 0% | 21 | $0.00 | |
| 81000 | 0% | 798 | $0.00 | |
| 3079F | 0% | 624 | $0.00 | |
| 92250 | 0% | 128 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 318 | $0.00 |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 493 | $0.00 |
| 92551 | 0% | 349 | $0.00 | |
| 3017F | 0% | 435 | $0.00 | |
| 1036F | 0% | 178 | $0.00 | |
| 3080F | 0% | 73 | $0.00 | |
| 3072F | 0% | 76 | $0.00 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 0% | 59 | $0.00 |
| 90651 | 0% | 13 | $0.00 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 24 | $0.00 |
| 1000F | 0% | 12 | $0.00 | |
| 90688 | 0% | 16 | $0.00 | |
| 3008F | 0% | 46 | $0.00 | |
| 90686 | 0% | 42 | $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.