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NPI 1306131545
NPI deactivated
1306131545
1306131545 was paid $13.76M by Medicaid between Jan 2018 and Aug 2022, across 103 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 84% of everything it billed.
33Billing provider info1306131545
33aNPI1306131545
33bProvider type—
28Total paid$13.76M
24GClaims159,858
24DCodes billed103
24AFirst – last monthJan 2018 – Aug 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 | 24,945 | $3.93M | |
| 2019 | 32,043 | $3.60M | |
| 2020 | 44,290 | $2.93M | |
| 2021 | 39,924 | $2.32M | |
| 2022 | 18,656 | $983K |
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 | 84% | 71,259 | 53,001 | $11.49M |
| 00003 | Internal/system code - not a standard HCPCS code | 14% | 10,323 | 9,091 | $1.98M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.0% | 19,701 | 16,703 | $140K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 4,709 | 4,356 | $69K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 297 | 267 | $31K |
| J3490 | Unclassified drugs | <1% | 189 | 169 | $12K |
| 0012A | <1% | 240 | 138 | $8K | |
| 0011A | <1% | 237 | 138 | $7K | |
| 0001A | <1% | 125 | 99 | $4K | |
| 0002A | <1% | 95 | 92 | $3K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 350 | 348 | $3K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 77 | 77 | $2K |
91 more codes
| 99000 | <1% | 6,547 | $2K | |
| 81025 | <1% | 939 | $2K | |
| 0064A | <1% | 29 | $1K | |
| 0071A | <1% | 18 | $680.00 | |
| 0004A | <1% | 13 | $480.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 275 | $359.40 |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 2,329 | $259.08 |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 508 | $70.13 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 624 | $25.75 |
| 81003 | <1% | 329 | $4.71 | |
| 81000 | <1% | 1,523 | $4.64 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,198 | $4.46 |
| 3351F | 0% | 537 | $0.00 | |
| 1220F | 0% | 3,617 | $0.00 | |
| D1310 | 0% | 522 | $0.00 | |
| Z1032 | 0% | 222 | $0.00 | |
| Z6204 | 0% | 67 | $0.00 | |
| D1330 | 0% | 749 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 3,577 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 6,918 | $0.00 |
| Z1034 | 0% | 2,622 | $0.00 | |
| Z6410 | 0% | 1,232 | $0.00 | |
| 90651 | 0% | 261 | $0.00 | |
| H0033 | Oral medication administration, direct observation | 0% | 12 | $0.00 |
| 90723 | 0% | 374 | $0.00 | |
| 90732 | 0% | 12 | $0.00 | |
| G9008 | Coordinated care fee, physician coordinated care oversight services | 0% | 56 | $0.00 |
| 90716 | 0% | 133 | $0.00 | |
| 85018 | 0% | 395 | $0.00 | |
| 36416 | 0% | 100 | $0.00 | |
| 90620 | 0% | 67 | $0.00 | |
| 1000F | 0% | 31 | $0.00 | |
| Z6406 | 0% | 243 | $0.00 | |
| 90647 | 0% | 372 | $0.00 | |
| 90686 | 0% | 1,209 | $0.00 | |
| 1031F | 0% | 238 | $0.00 | |
| 90744 | 0% | 30 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 22 | $0.00 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 193 | $0.00 |
| 90688 | 0% | 48 | $0.00 | |
| 99383 | 0% | 28 | $0.00 | |
| 92551 | 0% | 256 | $0.00 | |
| 99381 | 0% | 49 | $0.00 | |
| 4060F | 0% | 16 | $0.00 | |
| PSC | Zenith amniotic membrane psc | 0% | 13 | $0.00 |
| 99384 | 0% | 26 | $0.00 | |
| 3075F | 0% | 14 | $0.00 | |
| 3079F | 0% | 16 | $0.00 | |
| Z1038 | 0% | 31 | $0.00 | |
| 90696 | 0% | 13 | $0.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 0% | 21 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 18 | $0.00 |
| 3044F | 0% | 13 | $0.00 | |
| 96161 | 0% | 21 | $0.00 | |
| 90700 | 0% | 81 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 855 | $0.00 |
| 99173 | 0% | 1,160 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 1,812 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 556 | $0.00 |
| Z6400 | 0% | 209 | $0.00 | |
| 96160 | 0% | 2,342 | $0.00 | |
| 90670 | 0% | 641 | $0.00 | |
| 92552 | 0% | 843 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 146 | $0.00 |
| 83655 | 0% | 79 | $0.00 | |
| 90707 | 0% | 94 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 598 | $0.00 |
| 99215 | Doctor's office visit, returning patient (complex) | 0% | 16 | $0.00 |
| 90715 | 0% | 330 | $0.00 | |
| 90633 | 0% | 384 | $0.00 | |
| 90734 | 0% | 168 | $0.00 | |
| 90791 | Psychiatric diagnostic evaluation | 0% | 41 | $0.00 |
| Z6500 | 0% | 72 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 211 | $0.00 |
| 90473 | 0% | 93 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 186 | $0.00 |
| FLUVF | 0% | 14 | $0.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 12 | $0.00 |
| 90681 | 0% | 121 | $0.00 | |
| 92015 | Determination of refractive state | 0% | 175 | $0.00 |
| Z6414 | 0% | 12 | $0.00 | |
| 90713 | 0% | 55 | $0.00 | |
| 81002 | 0% | 16 | $0.00 | |
| 3077F | 0% | 12 | $0.00 | |
| 03 | Instill, bupivac and meloxic | 0% | 21 | $0.00 |
| 90710 | 0% | 12 | $0.00 | |
| 82948 | 0% | 77 | $0.00 | |
| 3078F | 0% | 28 | $0.00 | |
| 3046F | 0% | 14 | $0.00 | |
| 99001 | 0% | 30 | $0.00 | |
| 71046 | Radiologic examination, chest; 2 views | 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.