1104960491

1104960491 was paid $12K by Medicaid between Jun 2019 and Jul 2021, across 4 billing codes. Its largest line is V5257, Hearing aid, digital, monaural, bte — 74% of everything it billed.

33Billing provider info1104960491

33aNPI1104960491

33bProvider type—

28Total paid$12K

24GClaims129

24DCodes billed4

24AFirst – last monthJun 2019 – Jul 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
2019	48	$10K
2020	13	$332.24
2021	68	$2K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
V5257	Hearing aid, digital, monaural, bte	74%	12	12	$9K
V5266	Battery for use in hearing device	14%	64	62	$2K
V5264	Ear mold/insert, not disposable, any type	7.5%	26	24	$924.96
V5275	Ear impression, each	4.7%	27	24	$580.32

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.