1255840468

1255840468 was paid $998K by Medicaid between Jan 2018 and Aug 2019, across 21 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 98% of everything it billed.

33Billing provider info1255840468

33aNPI1255840468

33bProvider type—

28Total paid$998K

24GClaims16,120

24DCodes billed21

24AFirst – last monthJan 2018 – Aug 2019

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	9,284	$666K
2019	6,836	$332K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	98%	10,003	9,206	$976K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	3,138	2,948	$9K
90792	Psychiatric diagnostic evaluation with medical services	<1%	41	41	$8K
G0467	Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	<1%	136	126	$5K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	156	149	$427.80
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	313	250	$70.93
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	209	209	$33.73
90688		<1%	307	305	$21.93
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	422	420	$8.78
90472	Immunization administration, each additional vaccine (list separately)	<1%	45	45	$4.39
88142		0%	37	36	$0.00
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	0%	597	579	$0.00

9 more codes

82962		0%	110	$0.00
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	0%	108	$0.00
96127		0%	30	$0.00
86580		0%	14	$0.00
81002		0%	219	$0.00
59425		0%	100	$0.00
90715		0%	109	$0.00
81003		0%	13	$0.00
88164		0%	13	$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.