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NPI 1174501126
NPI deactivated
1174501126
1174501126 was paid $276K by Medicaid between Mar 2019 and Jul 2022, across 20 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.
33Billing provider info1174501126
33aNPI1174501126
33bProvider type—
28Total paid$276K
24GClaims9,337
24DCodes billed20
24AFirst – last monthMar 2019 – Jul 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 | |
|---|---|---|---|
| 2019 | 2,010 | $53K | |
| 2020 | 3,055 | $75K | |
| 2021 | 2,917 | $96K | |
| 2022 | 1,355 | $51K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 37% | 2,377 | 2,135 | $101K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 26% | 599 | 593 | $71K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 20% | 499 | 477 | $55K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.5% | 147 | 147 | $15K |
| 92553 | 4.6% | 1,648 | 1,581 | $13K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.5% | 1,231 | 1,186 | $10K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.7% | 706 | 678 | $5K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.6% | 1,283 | 1,241 | $4K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | <1% | 44 | 44 | $2K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 13 | 13 | $19.86 |
| 90651 | 0% | 285 | 267 | $0.00 | |
| 90620 | 0% | 59 | 59 | $0.00 |
8 more codes
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.