1336366756

1336366756 was paid $50K by Medicaid between Feb 2018 and Nov 2024, across 32 billing codes. Its largest line is 90460, Immunization administration through 18 years of age via any route, first or only component — 42% of everything it billed.

33Billing provider info1336366756

33aNPI1336366756

33bProvider type—

28Total paid$50K

24GClaims18,185

24DCodes billed32

24AFirst – last monthFeb 2018 – Nov 2024

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	1,381	$2K
2019	4,861	$17K
2020	3,764	$16K
2021	3,499	$5K
2022	2,203	$3K
2023	1,766	$5K
2024incomplete	711	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90460	Immunization administration through 18 years of age via any route, first or only component	42%	858	855	$21K
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	35%	672	634	$18K
87110		6.1%	136	136	$3K
D1206	Topical application of fluoride varnish	3.8%	85	85	$2K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	3.3%	840	765	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	3.2%	1,004	955	$2K
86580		2.3%	118	118	$1K
H0001	Alcohol and/or drug assessment	1.1%	730	694	$550.00
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	1.1%	196	196	$542.31
97803		<1%	1,456	1,425	$373.35
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	79	79	$223.36
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	<1%	167	162	$123.79

20 more codes

G9820	Documentation of a chlamydia screening test with proper follow-up	<1%	152	$75.00
97802		<1%	129	$65.97
90686		<1%	481	$58.59
3008F		<1%	3,391	$0.03
3016F		0%	609	$0.00
1033F		0%	969	$0.00
3725F		0%	1,173	$0.00
1003F		0%	1,359	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	126	$0.00
G0270	Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes	0%	13	$0.00
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	0%	15	$0.00
1000F		0%	659	$0.00
G9275	Documentation that patient is a current non-tobacco user	0%	568	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	0%	462	$0.00
1036F		0%	635	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	721	$0.00
G8418	Bmi is documented below normal parameters and a follow-up plan is documented	0%	181	$0.00
36415	Collection of venous blood by venipuncture	0%	172	$0.00
H0002	Behavioral health screening to determine eligibility for admission to treatment program	0%	12	$0.00
1031F		0%	17	$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.