1396831269

1396831269 was paid $859.34 by Medicaid between Mar 2018 and Jul 2020, across 4 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 79% of everything it billed.

33Billing provider info1396831269

33aNPI1396831269

33bProvider type—

28Total paid$859.34

24GClaims114

24DCodes billed4

24AFirst – last monthMar 2018 – Jul 2020

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	83	$305.85
2019	16	$553.49
2020	15	$0.00

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	79%	63	55	$680.99
J3250	Injection, trimethobenzamide hcl, up to 200 mg	21%	15	13	$178.35
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	0%	15	12	$0.00
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	0%	21	15	$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.