1528233459

1528233459 was paid $101K by Medicaid between Jan 2018 and Dec 2019, across 7 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 83% of everything it billed.

33Billing provider info1528233459

33aNPI1528233459

33bProvider type—

28Total paid$101K

24GClaims2,746

24DCodes billed7

24AFirst – last monthJan 2018 – Dec 2019

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	1,394	$50K
2019	1,352	$50K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	83%	2,101	1,320	$83K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	11%	166	152	$11K
D1206	Topical application of fluoride varnish	3.8%	210	205	$4K
92551		1.7%	160	157	$2K
99201		<1%	12	12	$478.32
99411		<1%	20	20	$281.01
99173		<1%	77	75	$153.72

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.