1215124797

1215124797 was paid $746K by Medicaid between Feb 2018 and Feb 2021, across 13 billing codes. Its largest line is J0135, Injection, adalimumab, 20 mg — 55% of everything it billed.

33Billing provider info1215124797

33aNPI1215124797

33bProvider type—

28Total paid$746K

24GClaims1,886

24DCodes billed13

24AFirst – last monthFeb 2018 – Feb 2021

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	734	$185K
2019	324	$7K
2020	694	$473K
2021	134	$81K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
J0135	Injection, adalimumab, 20 mg	55%	616	545	$408K
J3490	Unclassified drugs	26%	520	461	$196K
J3590	Unclassified biologics	16%	165	154	$119K
J2941	Injection, somatropin, 1 mg	2.0%	55	53	$15K
J1438	Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	<1%	91	67	$5K
J1726	Injection, hydroxyprogesterone caproate, (makena), 10 mg	<1%	13	13	$3K
90746		<1%	23	23	$270.37
90715		<1%	36	34	$142.11
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	178	156	$30.12
J1200	Injection, diphenhydramine hcl, up to 50 mg	0%	75	69	$0.00
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	0%	48	36	$0.00
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	0%	20	19	$0.00

1 more codes

J2469

Injection, palonosetron hcl, 25 mcg

$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.