1255849238

1255849238 was paid $1.35M by Medicaid between Mar 2018 and Apr 2022, across 68 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 36% of everything it billed.

33Billing provider info1255849238

33aNPI1255849238

33bProvider type—

28Total paid$1.35M

24GClaims42,154

24DCodes billed68

24AFirst – last monthMar 2018 – Apr 2022

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	12,474	$554K
2019	13,226	$418K
2020	7,387	$156K
2021	7,169	$177K
2022	1,898	$39K

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	36%	7,235	6,527	$486K
Z1034		19%	4,676	3,069	$257K
Z1032		7.3%	660	660	$98K
J3490	Unclassified drugs	5.7%	1,035	919	$77K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	5.1%	1,119	1,103	$69K
Z6500		3.5%	384	384	$48K
76815	Ultrasound, pregnant uterus, real time with image documentation, limited	2.7%	759	759	$37K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	2.4%	174	174	$32K
59409	Vaginal delivery only (with or without episiotomy and/or forceps)	2.2%	72	72	$30K
H1001	Prenatal care, at-risk enhanced service; antepartum management	1.6%	741	496	$22K
Z6400		1.6%	1,883	1,526	$21K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	1.2%	367	366	$16K

56 more codes

81025		1.1%	4,737	$14K
99213	Doctor's office visit, returning patient (routine)	1.1%	184	$14K
99000		<1%	4,552	$13K
Z6204		<1%	1,375	$13K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	<1%	297	$11K
Z6410		<1%	960	$9K
A4267	Contraceptive supply, condom, male, each	<1%	768	$9K
59425		<1%	298	$8K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	159	$8K
Z1038		<1%	143	$8K
Z6406		<1%	686	$7K
81002		<1%	3,403	$5K
99203	Doctor's office visit, new patient (routine)	<1%	12	$4K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	<1%	334	$3K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	54	$3K
92552		<1%	187	$3K
76813		<1%	27	$2K
92551		<1%	203	$2K
90670		<1%	252	$2K
57454		<1%	31	$2K
85018		<1%	781	$2K
81000		<1%	592	$2K
99381		<1%	12	$1K
Z6304		<1%	148	$1K
90658		<1%	116	$1K
S0197	Prenatal vitamins, 30-day supply	<1%	724	$993.15
Z6208		<1%	75	$987.88
Z6414		<1%	74	$866.77
90686		<1%	89	$783.00
90715		<1%	15	$531.80
90633		<1%	65	$459.00
H1003	Prenatal care, at-risk enhanced service; education	<1%	213	$424.16
90700		<1%	48	$378.00
90647		<1%	51	$364.50
Z6308		<1%	38	$327.78
90688		<1%	32	$288.00
Z6412		<1%	12	$246.82
90723		<1%	27	$207.00
90649		<1%	25	$207.00
90648		<1%	24	$162.00
90680		<1%	25	$144.00
90651		<1%	12	$108.00
90650		<1%	14	$90.00
90681		<1%	12	$90.00
97803		<1%	216	$82.34
99401		<1%	184	$67.30
92081		<1%	25	$30.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	<1%	16	$19.26
90685		<1%	12	$18.00
3008F		0%	288	$0.00
96151		0%	41	$0.00
3074F		0%	109	$0.00
3080F		0%	12	$0.00
0502F		0%	138	$0.00
3078F		0%	110	$0.00
3077F		0%	12	$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.