1467576843

1467576843 was paid $38K by Medicaid between Dec 2021 and Apr 2024, across 1 billing code. Its largest line is 00104, — 100% of everything it billed.

33Billing provider info1467576843

33aNPI1467576843

33bProvider type—

28Total paid$38K

24GClaims249

24DCodes billed1

24AFirst – last monthDec 2021 – Apr 2024

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
2021	32	$18K
2023	130	$12K
2024incomplete	87	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
00104		100%	249	80	$38K

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.