1255687653

1255687653 was paid $6K by Medicaid between Jan 2018 and Jan 2020, across 5 billing codes. Its largest line is 90715, — 59% of everything it billed.

33Billing provider info1255687653

33aNPI1255687653

33bProvider type—

28Total paid$6K

24GClaims464

24DCodes billed5

24AFirst – last monthJan 2018 – Jan 2020

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	172	$123.96
2019	263	$6K
2020	29	$45.68

Box 24 · Service lines

What it billed for

Code	Share	Claims	Bene. records	Paid
90715	59%	373	373	$4K
90739	41%	14	14	$2K
90732	0%	28	28	$0.00
90686	0%	12	12	$0.00
90736	0%	37	37	$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.