1104881242

1104881242 was paid $14K by Medicaid between Jan 2018 and Sep 2024, across 5 billing codes. Its largest line is 93970, — 66% of everything it billed.

33Billing provider info1104881242

33aNPI1104881242

33bProvider type—

28Total paid$14K

24GClaims815

24DCodes billed5

24AFirst – last monthJan 2018 – Sep 2024

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	265	$3K
2019	241	$4K
2020	166	$4K
2021	62	$1K
2022	12	$105.35
2023	25	$323.03
2024incomplete	44	$872.67

Box 24 · Service lines

What it billed for

Code	Share	Claims	Bene. records	Paid
93970	66%	460	435	$9K
78453	20%	244	238	$3K
78454	9.1%	77	76	$1K
93923	4.7%	22	16	$657.75
78580	<1%	12	12	$76.79

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.