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NPI 1386934214
NPI deactivated
1386934214
1386934214 was paid $2.33M by Medicaid between Jan 2018 and Jun 2019, across 52 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.
33Billing provider info1386934214
33aNPI1386934214
33bProvider type—
28Total paid$2.33M
24GClaims27,107
24DCodes billed52
24AFirst – last monthJan 2018 – Jun 2019
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 | 14,848 | $1.21M | |
| 2019 | 12,259 | $1.12M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 100% | 8,584 | 6,692 | $2.33M |
| 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% | 4,636 | 3,010 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,639 | 1,274 | $178.56 |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 2,472 | 1,986 | $103.08 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 449 | 402 | $77.93 |
| 90688 | <1% | 652 | 445 | $67.80 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 593 | 522 | $67.02 |
| 90715 | <1% | 115 | 100 | $60.52 | |
| 99051 | <1% | 326 | 270 | $41.64 | |
| 90686 | 0% | 697 | 584 | $0.00 | |
| 1220F | 0% | 326 | 288 | $0.00 | |
| 90716 | 0% | 180 | 162 | $0.00 |
40 more codes
| 90723 | 0% | 217 | $0.00 | |
| 90647 | 0% | 296 | $0.00 | |
| 96154 | 0% | 99 | $0.00 | |
| 90651 | 0% | 111 | $0.00 | |
| 90474 | 0% | 58 | $0.00 | |
| 90696 | 0% | 35 | $0.00 | |
| 1036F | 0% | 575 | $0.00 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 65 | $0.00 |
| 92551 | 0% | 195 | $0.00 | |
| 1125F | 0% | 120 | $0.00 | |
| 99381 | 0% | 12 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 23 | $0.00 |
| 1126F | 0% | 54 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 13 | $0.00 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 17 | $0.00 |
| 82962 | 0% | 13 | $0.00 | |
| 90620 | 0% | 16 | $0.00 | |
| 96127 | 0% | 21 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 413 | $0.00 |
| 81003 | 0% | 224 | $0.00 | |
| 99173 | 0% | 169 | $0.00 | |
| 90707 | 0% | 175 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 288 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 40 | $0.00 |
| 1003F | 0% | 139 | $0.00 | |
| 96152 | 0% | 724 | $0.00 | |
| 81002 | 0% | 35 | $0.00 | |
| 1159F | 0% | 289 | $0.00 | |
| 90670 | 0% | 417 | $0.00 | |
| 81025 | 0% | 77 | $0.00 | |
| 90700 | 0% | 177 | $0.00 | |
| 90681 | 0% | 181 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 219 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 535 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 14 | $0.00 |
| 90633 | 0% | 197 | $0.00 | |
| 90713 | 0% | 47 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 87 | $0.00 |
| 90734 | 0% | 38 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 13 | $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.