Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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1396828331

1396828331 was paid $781K by Medicaid between Jan 2018 and Dec 2021, across 96 billing codes. Its largest line is 99349, — 54% of everything it billed.

33Billing provider info1396828331
33aNPI1396828331
33bProvider type—
28Total paid$781K
24GClaims111,077
24DCodes billed96
24AFirst – last monthJan 2018 – Dec 2021
Box 24A · Dates of service

Paid by month

$0$20K$40K2018201920202021202220232024
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
YearClaimsPaid
201819,276$284K
201945,042$303K
202036,531$189K
202110,228$5K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99349 54% 7,266 6,692 $422K
99350 Prolong home eval add 15m 14% 1,310 1,243 $106K
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision of care plans 6.4% 1,621 1,574 $50K
99344 5.1% 402 400 $40K
99497 3.3% 425 405 $26K
99454 2.7% 833 804 $21K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2.3% 475 396 $18K
99457 1.8% 910 901 $14K
99348 1.7% 354 336 $13K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 1.5% 823 786 $11K
99345 Prolong home eval add 15m 1.1% 55 55 $8K
99496 <1% 31 31 $5K
84 more codes
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care <1% 316 $5K
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes <1% 404 $4K
96127 <1% 449 $3K
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications <1% 4,005 $3K
99401 <1% 223 $2K
99402 <1% 210 $2K
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care <1% 246 $2K
99406 <1% 110 $2K
1036F <1% 4,874 $1K
1090F <1% 4,975 $1K
1494F <1% 7,056 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 134 $1K
90674 <1% 206 $1K
0518F <1% 2,900 $1K
G8754 Most recent diastolic blood pressure < 90 mmhg <1% 2,399 $1K
99453 <1% 123 $1K
G0008 Administration of influenza virus vaccine <1% 252 $1K
1003F <1% 3,902 $997.19
1101F <1% 746 $989.15
G8734 Elder maltreatment screen documented as negative, follow-up is not required <1% 580 $954.31
G9903 Patient screened for tobacco use and identified as a tobacco non-user <1% 613 $855.22
3288F <1% 4,795 $831.86
1126F <1% 3,850 $818.41
G8950 Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented <1% 1,274 $805.35
G8753 Most recent systolic blood pressure >= 140 mmhg <1% 983 $625.32
G8731 Pain assessment using a standardized tool is documented as negative, no follow-up plan required <1% 2,042 $624.59
99203 Doctor's office visit, new patient (routine) <1% 13 $580.62
1111F <1% 527 $476.85
3725F <1% 666 $453.46
1160F <1% 7,380 $453.46
90686 <1% 142 $416.16
93000 <1% 27 $405.43
1091F <1% 394 $363.55
0521F <1% 2,222 $356.00
G9744 Patient not eligible due to active diagnosis of hypertension <1% 114 $262.05
1170F <1% 7,311 $261.77
99051 <1% 1,053 $257.97
99050 <1% 97 $247.15
G8752 Most recent systolic blood pressure < 140 mmhg <1% 1,702 $172.50
90682 <1% 40 $160.11
G0447 Face-to-face behavioral counseling for obesity, 15 minutes <1% 16 $126.24
94760 <1% 1,996 $117.95
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 42 $115.39
1159F <1% 7,607 $111.63
36415 Collection of venous blood by venipuncture <1% 135 $99.25
99439 0% 41 $0.00
4008F 0% 230 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 0% 17 $0.00
3075F 0% 366 $0.00
3079F 0% 297 $0.00
3008F 0% 1,435 $0.00
G9459 Currently a tobacco non-user 0% 931 $0.00
0509F 0% 999 $0.00
1125F 0% 2,005 $0.00
G9273 Blood pressure has a systolic value of < 140 and a diastolic value of < 90 0% 429 $0.00
3037F 0% 531 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 0% 395 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 0% 627 $0.00
3074F 0% 1,095 $0.00
3044F 0% 186 $0.00
1123F 0% 54 $0.00
G8418 Bmi is documented below normal parameters and a follow-up plan is documented 0% 118 $0.00
3080F 0% 65 $0.00
1034F 0% 239 $0.00
1157F 0% 620 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 0% 207 $0.00
G8478 Blood pressure measurement not performed or documented, reason not given 0% 14 $0.00
4010F 0% 43 $0.00
1158F 0% 1,618 $0.00
3077F 0% 414 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 0% 248 $0.00
4004F 0% 60 $0.00
4274F 0% 217 $0.00
4040F 0% 75 $0.00
G8730 Pain assessment documented as positive using a standardized tool and a follow-up plan is documented 0% 661 $0.00
G8783 Normal blood pressure reading documented, follow-up not required 0% 245 $0.00
3028F 0% 25 $0.00
1124F 0% 12 $0.00
G8476 Most recent blood pressure has a systolic measurement of < 140 mmhg and a diastolic measurement of < 90 mmhg 0% 65 $0.00
3078F 0% 1,716 $0.00
99072 0% 14 $0.00
4013F 0% 1,078 $0.00
94664 0% 15 $0.00
1033F 0% 14 $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.