1164699856

1164699856 was paid $4.20M by Medicaid between Jan 2018 and Apr 2019, across 3 billing codes. Its largest line is 90378, — 86% of everything it billed.

33Billing provider info1164699856

33aNPI1164699856

33bProvider type—

28Total paid$4.20M

24GClaims1,740

24DCodes billed3

24AFirst – last monthJan 2018 – Apr 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	1,102	$2.25M
2019	638	$1.94M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90378		86%	1,070	935	$3.61M
J3490	Unclassified drugs	14%	282	163	$568K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	388	372	$16K

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.