1093904914

1093904914 was paid $678K by Medicaid between Jan 2018 and Dec 2024, across 38 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 59% of everything it billed.

33Billing provider info1093904914

33aNPI1093904914

33bProvider type—

28Total paid$678K

24GClaims26,861

24DCodes billed38

24AFirst – last monthJan 2018 – Dec 2024

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

OIG exclusionListed on the federal exclusion list (05/25/2021).

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	5,758	$103K
2019	2,943	$140K
2020	5,831	$117K
2021	3,555	$113K
2022	1,656	$79K
2023	4,254	$72K
2024incomplete	2,864	$54K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	59%	6,713	5,655	$401K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	39%	3,936	3,314	$262K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	1.1%	107	87	$7K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	51	44	$5K
99348		<1%	43	36	$1K
99201		<1%	21	15	$741.55
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	15	13	$563.65
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	251	202	$443.60
Q3014	Telehealth originating site facility fee	<1%	39	18	$441.82
99347		<1%	12	12	$181.90
3078F		<1%	566	494	$75.00
3074F		<1%	721	619	$75.00

26 more codes

3079F		<1%	427	$50.00
90658		<1%	34	$34.11
3044F		<1%	336	$20.00
36415	Collection of venous blood by venipuncture	<1%	30	$5.85
3008F		<1%	1,821	$0.44
90674		<1%	33	$0.10
90686		<1%	14	$0.04
91301		<1%	18	$0.02
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month	0%	644	$0.00
1159F		0%	2,006	$0.00
3050F		0%	272	$0.00
81002		0%	123	$0.00
0521F		0%	388	$0.00
M1016	Female patients unable to bear children	0%	18	$0.00
3077F		0%	69	$0.00
G0466	Community health center visit, new patient	0%	13	$0.00
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	0%	18	$0.00
G0467	Community health center visit, returning patient	0%	3,134	$0.00
1125F		0%	418	$0.00
1126F		0%	584	$0.00
2001F		0%	1,724	$0.00
2000F		0%	1,730	$0.00
3075F		0%	16	$0.00
2010F		0%	388	$0.00
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	0%	99	$0.00
82962		0%	29	$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.