1487930301

1487930301 was paid $941K by Medicaid between Jan 2018 and Jun 2018, across 66 billing codes. Its largest line is 99284, emergency room visit (serious) — 32% of everything it billed.

33Billing provider info1487930301

33aNPI1487930301

33bProvider type—

28Total paid$941K

24GClaims16,144

24DCodes billed66

24AFirst – last monthJan 2018 – Jun 2018

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	16,144	$941K

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	32%	1,132	1,018	$300K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	26%	1,141	1,065	$243K
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	13%	531	462	$122K
74177	Computed tomography, abdomen and pelvis; with contrast material	10%	107	94	$94K
74176	Computed tomography, abdomen and pelvis; without contrast material	6.5%	105	98	$61K
70450	Computed tomography, head or brain; without contrast material	6.0%	204	188	$57K
72125	Computed tomography, cervical spine; without contrast material	2.1%	50	47	$19K
G0378	Hospital observation service, per hour	1.5%	90	44	$15K
99282	Emergency department visit for the evaluation and management, low to moderate severity	1.1%	88	86	$10K
99281	Emergency department visit for the evaluation and management, self-limited or minor	<1%	101	96	$7K
76497		<1%	13	13	$5K
96361	Intravenous infusion, hydration; each additional hour	<1%	384	332	$4K

54 more codes

96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour	<1%	64	$948.82
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	406	$706.86
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	<1%	181	$280.59
96374	Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance	<1%	487	$275.29
96375	Therapeutic injection; each additional sequential IV push	<1%	434	$78.56
87502	Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets	<1%	230	$77.00
J1885	Injection, ketorolac tromethamine, per 15 mg	<1%	311	$36.82
93005	Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	<1%	357	$29.84
71045	Radiologic examination, chest; single view	<1%	437	$28.83
80053	Comprehensive metabolic panel	<1%	939	$14.84
85027		<1%	1,148	$13.71
84484		<1%	322	$13.55
81025		<1%	127	$10.28
J8499	Prescription drug, oral, non chemotherapeutic, nos	<1%	911	$8.86
J2405	Injection, ondansetron hydrochloride, per 1 mg	<1%	461	$8.00
81002		<1%	613	$6.35
80048	Basic metabolic panel (calcium, ionized)	<1%	213	$5.82
J2060	Injection, lorazepam, 2 mg	<1%	267	$5.21
J1200	Injection, diphenhydramine hcl, up to 50 mg	<1%	77	$5.18
83690		<1%	297	$4.86
96360	Intravenous infusion, hydration; initial, 31 minutes to 1 hour	0%	109	$0.00
80305		0%	140	$0.00
J2270	Injection, morphine sulfate, up to 10 mg	0%	294	$0.00
J2550	Injection, promethazine hcl, up to 50 mg	0%	110	$0.00
76856	Ultrasound, pelvic (nonobstetric), real time with image documentation; complete	0%	33	$0.00
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	0%	185	$0.00
71046	Radiologic examination, chest; 2 views	0%	115	$0.00
76705	Ultrasound, abdominal, real time with image documentation; limited	0%	29	$0.00
84702		0%	32	$0.00
85610		0%	174	$0.00
J3475	Injection, magnesium sulfate, per 500 mg	0%	12	$0.00
96367		0%	14	$0.00
85730		0%	103	$0.00
82553		0%	113	$0.00
J0696	Injection, ceftriaxone sodium, per 250 mg	0%	180	$0.00
J1100	Injection, dexamethasone sodium phosphate, 1 mg	0%	119	$0.00
83605		0%	60	$0.00
J1170	Injection, hydromorphone, up to 4 mg	0%	155	$0.00
83735		0%	328	$0.00
84443	Thyroid stimulating hormone (TSH)	0%	82	$0.00
85379		0%	70	$0.00
J2001	Injection, lidocaine hcl for intravenous infusion, 10 mg	0%	105	$0.00
87807		0%	63	$0.00
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	0%	163	$0.00
84703		0%	242	$0.00
87040		0%	81	$0.00
83880		0%	35	$0.00
J3490	Unclassified drugs	0%	168	$0.00
82550		0%	209	$0.00
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	0%	253	$0.00
82150		0%	15	$0.00
J7644	Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram	0%	12	$0.00
96376		0%	77	$0.00
Q0162	Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen	0%	36	$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.