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NPI 1366047748
NPI deactivated
1366047748
1366047748 was paid $613K by Medicaid between Jan 2021 and Dec 2024, across 21 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 40% of everything it billed.
33Billing provider info1366047748
33aNPI1366047748
33bProvider type—
28Total paid$613K
24GClaims16,295
24DCodes billed21
24AFirst – last monthJan 2021 – Dec 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 | |
|---|---|---|---|
| 2021 | 2,256 | $89K | |
| 2022 | 2,893 | $87K | |
| 2023 | 2,641 | $109K | |
| 2024incomplete | 8,505 | $328K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 40% | 4,039 | 2,471 | $244K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 15% | 1,992 | 1,310 | $93K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | 14% | 678 | 455 | $85K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | 9.3% | 3,572 | 2,187 | $57K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 7.1% | 921 | 627 | $44K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.8% | 740 | 556 | $29K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 3.5% | 315 | 203 | $22K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 1.3% | 102 | 91 | $8K |
| 99199 | Unlisted special service, procedure or report | 1.1% | 2,436 | 2,258 | $7K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.0% | 92 | 70 | $6K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 635 | 393 | $6K |
| 99205 | Prolong outpt/office vis | <1% | 43 | 26 | $4K |
9 more codes
| 80305 | <1% | 445 | $3K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 46 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 71 | $2K |
| 99401 | <1% | 51 | $499.74 | |
| 80306 | <1% | 12 | $222.12 | |
| 96127 | <1% | 17 | $50.51 | |
| 81002 | <1% | 23 | $27.76 | |
| Q9992 | Injection, buprenorphine extended-release (sublocade), greater than 100 mg | <1% | 50 | $0.25 |
| G0008 | Administration of influenza virus vaccine | 0% | 15 | $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.