1396253340

1396253340 was paid $1.31M by Medicaid between Apr 2018 and Apr 2022, across 27 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 34% of everything it billed.

33Billing provider info1396253340

33aNPI1396253340

33bProvider type—

28Total paid$1.31M

24GClaims38,812

24DCodes billed27

24AFirst – last monthApr 2018 – Apr 2022

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	13,874	$529K
2019	10,543	$360K
2020	6,415	$170K
2021	6,200	$197K
2022	1,780	$54K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	34%	4,558	4,198	$447K
Z1034		17%	4,067	2,655	$224K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	9.8%	700	700	$129K
Z1032		8.5%	709	709	$111K
J3490	Unclassified drugs	7.4%	1,178	1,103	$97K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	7.2%	1,454	1,430	$95K
Z6500		3.5%	370	370	$46K
A4267	Contraceptive supply, condom, male, each	2.5%	2,957	2,945	$33K
76815	Ultrasound, pregnant uterus, real time with image documentation, limited	1.7%	424	424	$22K
81025		1.6%	6,709	6,438	$21K
99000		1.5%	5,727	5,299	$19K
Z6400		1.3%	1,476	1,235	$17K

15 more codes

H1001	Prenatal care, at-risk enhanced service; antepartum management	<1%	323	$12K
81002		<1%	4,406	$8K
Z6406		<1%	708	$8K
Z6204		<1%	738	$6K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	<1%	413	$5K
Z6410		<1%	569	$5K
Z6304		<1%	322	$3K
Z1038		<1%	27	$1K
S0197	Prenatal vitamins, 30-day supply	<1%	817	$1K
Z6412		<1%	24	$472.13
Z6414		<1%	28	$426.94
Z6308		<1%	28	$213.48
Z6208		<1%	28	$213.48
81000		<1%	32	$79.96
0502F		0%	20	$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.