1104971449

1104971449 was paid $119K by Medicaid between Jan 2018 and Dec 2018, across 85 billing codes. Its largest line is 99444, — 57% of everything it billed.

33Billing provider info1104971449

33aNPI1104971449

33bProvider type—

28Total paid$119K

24GClaims20,763

24DCodes billed85

24AFirst – last monthJan 2018 – Dec 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	20,763	$119K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99444		57%	1,185	375	$67K
95004	Percutaneous tests with allergenic extracts, immediate type reaction	8.8%	160	160	$10K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	6.5%	2,153	1,586	$8K
93306	Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete	4.3%	214	214	$5K
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	4.3%	654	576	$5K
93922		3.3%	496	475	$4K
93882		1.7%	205	204	$2K
99497		1.7%	258	254	$2K
93976		1.6%	88	77	$2K
20611		1.5%	285	271	$2K
93923		1.3%	236	236	$2K
20553		1.2%	362	327	$1K

73 more codes

76536		1.1%	146	$1K
95250		<1%	129	$1K
95251		<1%	132	$731.50
93880		<1%	41	$694.77
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	365	$687.42
96360	Intravenous infusion, hydration; initial, 31 minutes to 1 hour	<1%	72	$492.10
94060		<1%	171	$489.11
93925		<1%	19	$488.79
93224		<1%	72	$427.45
71046	Radiologic examination, chest; 2 views	<1%	222	$268.00
99203	Doctor's office visit, new patient (routine)	<1%	12	$208.28
93005	Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	<1%	256	$206.72
G0179	Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	<1%	223	$154.69
83880		<1%	28	$140.80
80053	Comprehensive metabolic panel	<1%	579	$120.71
83036	Hemoglobin; glycosylated (A1C)	<1%	461	$115.25
93701		<1%	17	$100.90
76705	Ultrasound, abdominal, real time with image documentation; limited	<1%	77	$88.30
73030		<1%	60	$72.17
51701		<1%	13	$71.65
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	13	$69.99
84443	Thyroid stimulating hormone (TSH)	<1%	124	$58.08
92567		<1%	167	$55.98
82553		<1%	92	$55.02
84484		<1%	92	$53.22
72050		<1%	97	$49.35
84480		<1%	96	$49.02
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	75	$37.17
72110		<1%	45	$36.89
20552		<1%	13	$34.86
72070		<1%	14	$32.16
82044		<1%	389	$31.48
84439		<1%	96	$31.17
81003		<1%	717	$31.07
86430		<1%	26	$23.52
80061	Lipid panel	<1%	209	$20.07
84550		<1%	30	$18.76
73560		<1%	40	$13.60
82948		<1%	1,186	$11.53
80048	Basic metabolic panel (calcium, ionized)	<1%	323	$9.74
83735		<1%	19	$6.95
86140		<1%	12	$5.37
51798		<1%	30	$4.80
84100		<1%	19	$4.56
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	57	$1.62
J1020	Injection, methylprednisolone acetate, 20 mg	0%	360	$0.00
G0446	Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	0%	161	$0.00
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	0%	169	$0.00
1090F		0%	257	$0.00
3288F		0%	257	$0.00
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	0%	142	$0.00
76775		0%	14	$0.00
G8431	Screening for depression is documented as being positive and a follow-up plan is documented	0%	216	$0.00
74018		0%	61	$0.00
G0246	Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education	0%	43	$0.00
99490	Ccm add 20min	0%	101	$0.00
86677		0%	85	$0.00
77080		0%	79	$0.00
85025	Blood count; complete (CBC), automated, and automated differential WBC count	0%	539	$0.00
1126F		0%	1,654	$0.00
1170F		0%	258	$0.00
90688		0%	140	$0.00
76700	Ultrasound, abdominal, real time with image documentation; complete	0%	24	$0.00
J1030	Injection, methylprednisolone acetate, 40 mg	0%	347	$0.00
86063		0%	12	$0.00
36415	Collection of venous blood by venipuncture	0%	753	$0.00
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	0%	256	$0.00
G0008	Administration of influenza virus vaccine	0%	140	$0.00
1125F		0%	1,156	$0.00
3044F		0%	42	$0.00
3061F		0%	18	$0.00
G8430	Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status)	0%	95	$0.00
G0180	Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	0%	12	$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.