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NPI 1316455363
NPI deactivated
1316455363
1316455363 was paid $1.51M by Medicaid between Feb 2018 and Apr 2022, across 98 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 28% of everything it billed.
33Billing provider info1316455363
33aNPI1316455363
33bProvider type—
28Total paid$1.51M
24GClaims101,489
24DCodes billed98
24AFirst – last monthFeb 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 | 32,923 | $522K | |
| 2019 | 28,526 | $407K | |
| 2020 | 17,276 | $237K | |
| 2021 | 17,041 | $275K | |
| 2022 | 5,723 | $66K |
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 | 28% | 14,799 | 13,125 | $417K |
| Z1034 | 17% | 4,705 | 3,073 | $258K | |
| Z1032 | 6.4% | 642 | 642 | $96K | |
| 99381 | 4.4% | 626 | 625 | $66K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.2% | 3,154 | 2,964 | $63K |
| J3490 | Unclassified drugs | 3.9% | 788 | 728 | $59K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.9% | 951 | 948 | $59K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 3.8% | 319 | 311 | $57K |
| Z6500 | 3.6% | 448 | 448 | $55K | |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | 3.4% | 4,745 | 3,068 | $52K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 2.1% | 1,353 | 1,287 | $32K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 2.1% | 1,236 | 1,230 | $32K |
86 more codes
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.6% | 1,190 | $24K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 1.4% | 121 | $21K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.1% | 629 | $16K |
| Z6406 | 1.1% | 1,392 | $16K | |
| 99000 | 1.0% | 8,751 | $15K | |
| Z6400 | 1.0% | 1,456 | $15K | |
| Z6204 | <1% | 1,308 | $15K | |
| 81025 | <1% | 5,176 | $13K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 113 | $11K |
| G9920 | Screening performed and negative | <1% | 463 | $11K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 768 | $11K |
| A4267 | Contraceptive supply, condom, male, each | <1% | 808 | $9K |
| 81002 | <1% | 9,250 | $9K | |
| S9445 | Patient education, not otherwise classified, non-physician provider, individual, per session | <1% | 1,595 | $8K |
| 90670 | <1% | 1,028 | $6K | |
| 59514 | <1% | 28 | $6K | |
| 76813 | <1% | 85 | $6K | |
| 90723 | <1% | 555 | $4K | |
| 90648 | <1% | 542 | $4K | |
| 90680 | <1% | 560 | $4K | |
| Z6304 | <1% | 448 | $4K | |
| 92551 | <1% | 552 | $3K | |
| Z1038 | <1% | 55 | $3K | |
| Z6410 | <1% | 254 | $3K | |
| H1000 | Prenatal care, at-risk assessment | <1% | 208 | $3K |
| 90715 | <1% | 128 | $2K | |
| 90647 | <1% | 383 | $2K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 78 | $2K |
| 85018 | <1% | 2,288 | $2K | |
| Z6414 | <1% | 120 | $1K | |
| H1003 | Prenatal care, at-risk enhanced service; education | <1% | 2,325 | $1K |
| 90685 | <1% | 185 | $1K | |
| 99284 | Emergency room visit (serious) | <1% | 31 | $1K |
| 90686 | <1% | 286 | $1K | |
| 92552 | <1% | 732 | $1K | |
| S0197 | Prenatal vitamins, 30-day supply | <1% | 889 | $953.04 |
| 90700 | <1% | 202 | $792.00 | |
| 59430 | <1% | 332 | $786.20 | |
| 90633 | <1% | 226 | $657.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 163 | $643.98 |
| 81000 | <1% | 1,389 | $569.16 | |
| 90688 | <1% | 21 | $450.77 | |
| 59425 | <1% | 2,374 | $435.42 | |
| 97803 | <1% | 1,777 | $427.58 | |
| 85014 | <1% | 347 | $361.79 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 276 | $348.45 |
| 90716 | <1% | 57 | $225.00 | |
| 90707 | <1% | 55 | $225.00 | |
| 90658 | <1% | 106 | $216.00 | |
| Z6208 | <1% | 14 | $166.54 | |
| Z6308 | <1% | 14 | $105.98 | |
| 3074F | <1% | 1,314 | $20.00 | |
| 99401 | <1% | 1,683 | $16.82 | |
| 96156 | <1% | 172 | $13.46 | |
| 3008F | <1% | 2,880 | $10.00 | |
| 99173 | <1% | 497 | $9.58 | |
| 90657 | <1% | 25 | $9.00 | |
| 90649 | <1% | 24 | $9.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 27 | $0.00 |
| 3079F | 0% | 352 | $0.00 | |
| 96151 | 0% | 551 | $0.00 | |
| S9452 | Nutrition classes, non-physician provider, per session | 0% | 125 | $0.00 |
| H2000 | Comprehensive multidisciplinary evaluation | 0% | 267 | $0.00 |
| 3080F | 0% | 1,383 | $0.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 19 | $0.00 |
| 0500F | 0% | 26 | $0.00 | |
| 86580 | 0% | 44 | $0.00 | |
| 90650 | 0% | 13 | $0.00 | |
| 0503F | 0% | 73 | $0.00 | |
| 4037F | 0% | 20 | $0.00 | |
| 3075F | 0% | 65 | $0.00 | |
| 3044F | 0% | 14 | $0.00 | |
| 93000 | 0% | 18 | $0.00 | |
| 3078F | 0% | 1,141 | $0.00 | |
| 1159F | 0% | 1,178 | $0.00 | |
| 92081 | 0% | 742 | $0.00 | |
| 3077F | 0% | 1,484 | $0.00 | |
| 4120F | 0% | 236 | $0.00 | |
| 96152 | 0% | 91 | $0.00 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 0% | 79 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 12 | $0.00 |
| 3725F | 0% | 31 | $0.00 | |
| 90713 | 0% | 55 | $0.00 | |
| 0502F | 0% | 900 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 17 | $0.00 |
| 1160F | 0% | 32 | $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.