1376909036

1376909036 was paid $701K by Medicaid between Jan 2018 and Dec 2024, across 46 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 64% of everything it billed.

33Billing provider info1376909036

33aNPI1376909036

33bProvider type—

28Total paid$701K

24GClaims28,709

24DCodes billed46

24AFirst – last monthJan 2018 – 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
2018	3,059	$65K
2019	3,920	$118K
2020	6,875	$177K
2021	6,264	$150K
2022	6,307	$157K
2023	2,116	$28K
2024incomplete	168	$6K

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	64%	11,736	9,385	$449K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	11%	2,730	2,317	$75K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	10%	1,201	1,024	$71K
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	4.2%	519	443	$29K
99401		3.5%	1,915	1,696	$24K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	2.2%	286	264	$15K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	1.5%	220	203	$11K
90792	Psychiatric diagnostic evaluation with medical services	1.1%	166	110	$8K
99406		<1%	1,231	863	$3K
99404		<1%	87	51	$2K
80305		<1%	266	192	$2K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	<1%	43	39	$2K

34 more codes

90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	140	$2K
99205	Prolong outpt/office vis	<1%	21	$2K
90688		<1%	111	$1K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	60	$1K
99403		<1%	67	$1K
36415	Collection of venous blood by venipuncture	<1%	479	$641.20
96127		<1%	442	$528.65
96160		<1%	574	$350.10
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	52	$333.27
90756		<1%	13	$205.11
96161		<1%	48	$112.20
3077F		<1%	58	$30.00
3080F		<1%	44	$30.00
81005		<1%	31	$16.86
3078F		<1%	55	$15.00
3074F		<1%	149	$15.00
3725F		0%	1,838	$0.00
4551F		0%	46	$0.00
4004F		0%	525	$0.00
G8483	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	0%	56	$0.00
1159F		0%	25	$0.00
1160F		0%	35	$0.00
G8482	Influenza immunization administered or previously received	0%	36	$0.00
1158F		0%	17	$0.00
1034F		0%	238	$0.00
99000		0%	87	$0.00
3008F		0%	2,453	$0.00
0545F		0%	203	$0.00
1030F		0%	109	$0.00
1000F		0%	173	$0.00
1220F		0%	59	$0.00
1170F		0%	17	$0.00
2001F		0%	20	$0.00
2060F		0%	28	$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.