1336299403

1336299403 was paid $564K by Medicaid between Jan 2018 and Dec 2022, across 29 billing codes. Its largest line is 95004, Percutaneous tests with allergenic extracts, immediate type reaction — 66% of everything it billed.

33Billing provider info1336299403

33aNPI1336299403

33bProvider type—

28Total paid$564K

24GClaims20,165

24DCodes billed29

24AFirst – last monthJan 2018 – Dec 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	5,456	$162K
2019	4,983	$176K
2020	3,865	$127K
2021	2,882	$45K
2022	2,979	$54K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
95004	Percutaneous tests with allergenic extracts, immediate type reaction	66%	2,250	2,231	$371K
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	10%	3,717	3,584	$58K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	8.8%	5,761	5,215	$50K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	3.1%	336	334	$18K
92552		2.9%	1,504	1,499	$17K
94060		2.7%	340	335	$15K
87430		1.3%	872	862	$7K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	1.3%	163	163	$7K
92081		<1%	1,095	1,094	$4K
92550		<1%	221	218	$4K
85013		<1%	1,139	1,135	$3K
81000		<1%	829	828	$2K

17 more codes

G9920	Screening performed and negative	<1%	488	$2K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	13	$1K
90658		<1%	176	$1K
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	83	$699.82
90715		<1%	28	$595.25
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	<1%	13	$523.44
85014		<1%	257	$517.69
90649		<1%	40	$429.81
90686		<1%	35	$397.76
90651		<1%	25	$331.97
85018		<1%	116	$277.68
81002		<1%	104	$237.31
99173		<1%	112	$173.05
69210		<1%	30	$137.05
81001		<1%	387	$126.84
90700		<1%	16	$122.85
90734		<1%	15	$113.40

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.