Form, Jacob
Form, Jacob was paid $13K by Medicaid between Apr 2018 and Nov 2024, across 5 billing codes. Its largest line is 11721, — 76% of everything it billed.
33Billing provider infoFORM, JACOB
LAFAYETTE HILL, PA 19444
LAFAYETTE HILL, PA 19444
33aNPI1356367494assigned 07/14/2006
33bProvider typePodiatrist
28Total paid$13K
24GClaims2,647
24DCodes billed5
24AFirst – last monthApr 2018 – Nov 2024
Compared with peers
Next to other Podiatrist providers in Pennsylvania
Rank by total paid#76 of 262
Median peer was paid$3K
This provider vs. median4.3×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
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 | 63 | $0.00 | |
| 2020 | 142 | $336.23 | |
| 2021 | 854 | $5K | |
| 2022 | 752 | $5K | |
| 2023 | 408 | $2K | |
| 2024incomplete | 428 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 11721 | 76% | 2,062 | 2,033 | $10K | |
| 11720 | 21% | 520 | 516 | $3K | |
| 99307 | 3.0% | 41 | 41 | $401.94 | |
| 11719 | 0% | 12 | 12 | $0.00 | |
| 99348 | 0% | 12 | 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.