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NPI 1124150545
NPI deactivated
1124150545
1124150545 was paid $141.70 by Medicaid between Jan 2018 and Jul 2018, across 34 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider info1124150545
33aNPI1124150545
33bProvider type—
28Total paid$141.70
24GClaims41,577
24DCodes billed34
24AFirst – last monthJan 2018 – Jul 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 | 41,577 | $141.70 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 34% | 3,713 | 3,499 | $48.00 |
| 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 | 26% | 3,421 | 3,285 | $37.50 |
| 96150 | 25% | 1,265 | 1,255 | $36.06 | |
| 81003 | 11% | 848 | 750 | $15.68 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.1% | 268 | 267 | $4.46 |
| 3008F | 0% | 4,915 | 4,630 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 454 | 444 | $0.00 |
| 1036F | 0% | 3,912 | 3,706 | $0.00 | |
| 3074F | 0% | 6,705 | 6,247 | $0.00 | |
| 3079F | 0% | 538 | 525 | $0.00 | |
| 99000 | 0% | 673 | 645 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 733 | 728 | $0.00 |
22 more codes
| 1000F | 0% | 4,118 | $0.00 | |
| 85018 | 0% | 135 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 74 | $0.00 |
| 3075F | 0% | 303 | $0.00 | |
| 90688 | 0% | 53 | $0.00 | |
| 94760 | 0% | 35 | $0.00 | |
| 3078F | 0% | 7,097 | $0.00 | |
| 82948 | 0% | 737 | $0.00 | |
| S0197 | Prenatal vitamins, 30-day supply | 0% | 25 | $0.00 |
| 99173 | 0% | 204 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 97 | $0.00 |
| 3077F | 0% | 301 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 14 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 213 | $0.00 |
| H1002 | Prenatal care, at risk enhanced service; care coordination | 0% | 47 | $0.00 |
| A4550 | Surgical trays | 0% | 39 | $0.00 |
| 99201 | 0% | 228 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 14 | $0.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 215 | $0.00 |
| 92552 | 0% | 93 | $0.00 | |
| 81025 | 0% | 76 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 14 | $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.