1134202278

1134202278 was paid $45K by Medicaid between Jan 2018 and Jun 2022, across 20 billing codes. Its largest line is 11721, — 31% of everything it billed.

33Billing provider info1134202278

33aNPI1134202278

33bProvider type—

28Total paid$45K

24GClaims10,182

24DCodes billed20

24AFirst – last monthJan 2018 – Jun 2022

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	4,769	$7K
2019	3,224	$9K
2020	1,030	$10K
2021	799	$13K
2022	360	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
11721		31%	429	427	$14K
11720		15%	276	275	$7K
11730		15%	304	301	$7K
11056		15%	1,294	1,291	$7K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	15%	1,521	1,376	$7K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	8.7%	319	305	$4K
1123F		<1%	579	533	$93.45
3044F		<1%	441	399	$46.91
G8410	Footwear evaluation performed and documented	<1%	438	397	$18.16
G8404	Lower extremity neurological exam performed and documented	<1%	439	398	$0.06
G8442	Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounter	0%	597	536	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	563	519	$0.00

8 more codes

4040F		0%	582	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	583	$0.00
G8482	Influenza immunization administered or previously received	0%	580	$0.00
A5512	For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each	0%	13	$0.00
A5500	For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe	0%	26	$0.00
1036F		0%	605	$0.00
G8950	Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented	0%	580	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	13	$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.