1366850091

1366850091 was paid $155K by Medicaid between Jan 2018 and Sep 2018, across 15 billing codes. Its largest line is 99203, doctor's office visit, new patient (routine) — 34% of everything it billed.

33Billing provider info1366850091

33aNPI1366850091

33bProvider type—

28Total paid$155K

24GClaims5,611

24DCodes billed15

24AFirst – last monthJan 2018 – Sep 2018

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	5,611	$155K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	34%	988	917	$53K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	31%	2,094	1,858	$48K
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	15%	661	623	$23K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	10%	482	452	$16K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	5.7%	527	379	$9K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	2.4%	210	196	$4K
90715		<1%	17	17	$526.15
81003		<1%	281	250	$502.46
J1741	Injection, ibuprofen, 100 mg	<1%	39	39	$367.95
J0131	Injection, acetaminophen, not otherwise specified,10 mg	<1%	115	96	$238.47
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	16	16	$181.05
81025		<1%	62	54	$160.66

3 more codes

J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	70	$119.70
81002		<1%	22	$36.21
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	27	$21.95

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.