1396864542

1396864542 was paid $25.10M by Medicaid between Jan 2018 and Aug 2022, across 104 billing codes. Its largest line is 99284, emergency room visit (serious) — 35% of everything it billed.

33Billing provider info1396864542

33aNPI1396864542

33bProvider type—

28Total paid$25.10M

24GClaims121,267

24DCodes billed104

24AFirst – last monthJan 2018 – Aug 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	33,397	$7.51M
2019	36,298	$7.91M
2020	16,981	$3.45M
2021	20,972	$3.64M
2022	13,619	$2.59M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	35%	7,833	6,652	$8.66M
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	19%	3,430	2,867	$4.85M
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	15%	7,169	6,165	$3.68M
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	2.8%	10,716	8,074	$708K
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	2.7%	5,340	1,359	$678K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	2.3%	8,343	6,706	$579K
G0378	Hospital observation service, per hour	2.3%	336	316	$579K
93306	Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete	2.0%	1,001	694	$505K
99219		1.4%	230	200	$356K
99220		1.3%	210	163	$339K
99282	Emergency department visit for the evaluation and management, low to moderate severity	1.3%	1,006	900	$327K
77067	Screening mammography, bilateral, including computer-aided detection	1.1%	1,664	1,515	$283K

92 more codes

82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	<1%	1,931	$208K
80061	Lipid panel	<1%	3,895	$190K
84443	Thyroid stimulating hormone (TSH)	<1%	3,084	$188K
97530	Therapeutic activities, direct patient contact, each 15 minutes	<1%	2,046	$184K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	<1%	1,430	$164K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	5,390	$153K
87389	Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies	<1%	1,892	$142K
80048	Basic metabolic panel (calcium, ionized)	<1%	3,808	$138K
92507	Treatment of speech, language, voice, communication, and/or auditory processing disorder	<1%	1,505	$131K
87491	Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe	<1%	944	$123K
80050	General health panel	<1%	965	$122K
87591	Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe	<1%	922	$120K
80053	Comprehensive metabolic panel	<1%	2,674	$116K
93005	Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	<1%	1,184	$104K
83036	Hemoglobin; glycosylated (A1C)	<1%	2,914	$103K
97140	Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage)	<1%	1,486	$90K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2	<1%	1,171	$82K
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	<1%	371	$75K
85027		<1%	2,967	$70K
77063	Screening digital breast tomosynthesis, bilateral	<1%	1,572	$68K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	<1%	1,044	$67K
86780		<1%	1,326	$62K
82607		<1%	1,097	$61K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	707	$58K
86803		<1%	1,081	$56K
80076		<1%	1,593	$48K
82728		<1%	864	$43K
59025	Fetal non-stress test	<1%	166	$43K
84439		<1%	921	$30K
85610		<1%	2,047	$29K
83550		<1%	897	$29K
81001		<1%	2,199	$26K
82565		<1%	1,272	$24K
86618		<1%	266	$23K
83735		<1%	914	$23K
87086	Culture, bacterial; quantitative colony count, urine	<1%	913	$23K
87340		<1%	543	$20K
71046	Radiologic examination, chest; 2 views	<1%	196	$19K
86850		<1%	1,028	$14K
83615		<1%	612	$14K
80051		<1%	524	$14K
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	<1%	1,184	$11K
86901		<1%	1,011	$11K
86900		<1%	1,010	$11K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	<1%	95	$11K
82746		<1%	195	$11K
84460		<1%	568	$11K
82570		<1%	555	$10K
84702		<1%	192	$10K
84450		<1%	546	$10K
93017		<1%	65	$10K
85652		<1%	971	$10K
84520		<1%	635	$9K
86762		<1%	173	$9K
87088		<1%	295	$9K
80305		<1%	248	$8K
76642		<1%	86	$8K
82043		<1%	395	$8K
88175	Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer	<1%	82	$7K
95806		<1%	28	$6K
94060		<1%	20	$6K
84100		<1%	311	$6K
97161		<1%	58	$6K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	55	$5K
87070		<1%	165	$5K
86140		<1%	264	$5K
94729		<1%	65	$5K
82947		<1%	311	$4K
81025		<1%	169	$4K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	90	$4K
87637	Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV	<1%	20	$3K
87186		<1%	78	$3K
81002		<1%	252	$2K
81003		<1%	244	$2K
71250		<1%	12	$2K
83655		<1%	57	$2K
93018		<1%	62	$2K
82248		<1%	92	$2K
G0499	Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result	<1%	15	$2K
85730		<1%	75	$2K
84481		<1%	20	$1K
87077		<1%	34	$1K
J7030	Infusion, normal saline solution , 1000 cc	<1%	13	$720.00
85046		<1%	31	$683.01
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	16	$666.08
86706		<1%	18	$662.94
82550		<1%	27	$633.99
86431		<1%	29	$611.13
82950		<1%	33	$537.24
84550		<1%	12	$219.96
90686		<1%	522	$5.23
90674		<1%	124	$1.24

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.