1154791853

1154791853 was paid $875K by Medicaid between Feb 2018 and Aug 2019, across 1 billing code. Its largest line is Y9504, — 100% of everything it billed.

33Billing provider info1154791853

33aNPI1154791853

33bProvider type—

28Total paid$875K

24GClaims462

24DCodes billed1

24AFirst – last monthFeb 2018 – Aug 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	240	$463K
2019	222	$412K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
Y9504		100%	462	342	$875K

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.