Petrie, Louis
Petrie, Louis was paid $1K by Medicaid between Oct 2018 and Oct 2018, across 2 billing codes. Its largest line is 90662, — 100% of everything it billed.
33Billing provider infoPETRIE, LOUIS
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
33aNPI1154682243assigned 06/05/2012
33bProvider typePharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
28Total paid$1K
24GClaims40
24DCodes billed2
24AFirst – last monthOct 2018 – Oct 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 | 40 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90662 | 100% | 20 | 20 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 20 | 20 | $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.