1205877354

1205877354 was paid $252K by Medicaid between Jan 2018 and Feb 2018, across 50 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 46% of everything it billed.

33Billing provider info1205877354

33aNPI1205877354

33bProvider type—

28Total paid$252K

24GClaims8,756

24DCodes billed50

24AFirst – last monthJan 2018 – Feb 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	8,756	$252K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	46%	2,367	1,407	$116K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	18%	346	206	$46K
Z1034		6.3%	285	187	$16K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	5.3%	281	146	$13K
J3490	Unclassified drugs	5.2%	161	87	$13K
Z1032		3.7%	60	60	$9K
Z6500		3.2%	64	64	$8K
A4267	Contraceptive supply, condom, male, each	1.9%	429	424	$5K
59409	Vaginal delivery only (with or without episiotomy and/or forceps)	1.2%	18	18	$3K
76815	Ultrasound, pregnant uterus, real time with image documentation, limited	1.1%	86	86	$3K
Z6400		<1%	207	162	$2K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	<1%	220	218	$2K

38 more codes

76813		<1%	32	$2K
81025		<1%	802	$2K
Z6204		<1%	174	$2K
Z6406		<1%	149	$1K
99402		<1%	34	$1K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	53	$1K
Z6304		<1%	91	$759.30
Z1038		<1%	12	$658.61
Z6410		<1%	69	$651.80
99401		<1%	153	$438.61
99213	Doctor's office visit, returning patient (routine)	<1%	609	$420.04
81002		<1%	280	$376.02
92552		<1%	107	$370.37
90670		<1%	66	$279.00
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	49	$226.92
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	15	$193.30
S0197	Prenatal vitamins, 30-day supply	<1%	170	$189.70
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	<1%	41	$177.06
90680		<1%	25	$162.00
Z6414		<1%	15	$152.16
90723		<1%	13	$108.00
90630		<1%	106	$92.40
92081		<1%	72	$56.34
90647		<1%	18	$45.00
81000		<1%	80	$41.64
85018		<1%	74	$28.87
90633		<1%	22	$18.00
90707		<1%	16	$18.00
90716		<1%	19	$18.00
86580		<1%	14	$6.66
H1003	Prenatal care, at-risk enhanced service; education	0%	232	$0.00
59425		0%	312	$0.00
99215	Doctor's office visit, returning patient (complex)	0%	15	$0.00
97803		0%	144	$0.00
59430		0%	17	$0.00
96151		0%	79	$0.00
H2000	Comprehensive multidisciplinary evaluation	0%	39	$0.00
S9452	Nutrition classes, non-physician provider, per session	0%	14	$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.