1508057639

1508057639 was paid $160K by Medicaid between Oct 2019 and Apr 2022, across 6 billing codes. Its largest line is 93975, — 49% of everything it billed.

33Billing provider info1508057639

33aNPI1508057639

33bProvider type—

28Total paid$160K

24GClaims1,189

24DCodes billed6

24AFirst – last monthOct 2019 – Apr 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
2019	194	$21K
2020	485	$63K
2021	295	$47K
2022	215	$30K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
93975		49%	301	299	$78K
76830	Ultrasound, transvaginal	20%	412	405	$31K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	17%	409	357	$28K
58558		10%	12	12	$16K
93976		3.6%	43	41	$6K
57180		<1%	12	12	$1K

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.