1154596625

1154596625 was paid $25K by Medicaid between Jan 2018 and Nov 2019, across 7 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 72% of everything it billed.

33Billing provider info1154596625

33aNPI1154596625

33bProvider type—

28Total paid$25K

24GClaims906

24DCodes billed7

24AFirst – last monthJan 2018 – Nov 2019

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	503	$13K
2019	403	$12K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	72%	457	358	$18K
D1206	Topical application of fluoride varnish	12%	156	154	$3K
92551		6.4%	154	154	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	4.3%	17	17	$1K
99201		3.6%	23	23	$888.88
99411		<1%	16	16	$221.85
99173		<1%	83	82	$201.60

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.