Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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NPI deactivated

1174690101

1174690101 was paid $5K by Medicaid between Jan 2018 and Feb 2020, across 30 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 62% of everything it billed.

33Billing provider info1174690101
33aNPI1174690101
33bProvider type—
28Total paid$5K
24GClaims7,273
24DCodes billed30
24AFirst – last monthJan 2018 – Feb 2020
Box 24A · Dates of service

Paid by month

$0$200$400$6002018201920202021202220232024
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
YearClaimsPaid
20183,560$2K
20193,005$2K
2020708$270.12
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 62% 706 660 $3K
3074F 15% 449 414 $722.50
3078F 8.9% 314 292 $440.50
83036 Hemoglobin; glycosylated (A1C) 6.4% 43 41 $320.00
3044F 3.5% 446 410 $176.00
3048F 1.3% 139 127 $64.00
1126F <1% 65 61 $44.00
36415 Collection of venous blood by venipuncture <1% 133 131 $36.00
1159F <1% 106 101 $35.00
1160F <1% 106 101 $17.50
3079F <1% 32 28 $16.00
1125F <1% 12 12 $10.00
18 more codes
3049F <1% 59 $8.00
H0001 Alcohol and/or drug assessment <1% 69 $3.75
3008F <1% 441 $0.10
3062F <1% 332 $0.05
3725F 0% 118 $0.00
77057 0% 20 $0.00
3016F 0% 64 $0.00
G9621 Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling 0% 45 $0.00
G9622 Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method 0% 62 $0.00
0521F 0% 46 $0.00
2001F 0% 772 $0.00
2000F 0% 806 $0.00
1036F 0% 272 $0.00
2010F 0% 771 $0.00
G8725 Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol) 0% 84 $0.00
1000F 0% 576 $0.00
3060F 0% 44 $0.00
3014F 0% 141 $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.