1568983575

1568983575 was paid $1.81M by Medicaid between Jan 2018 and Jun 2021, across 47 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 57% of everything it billed.

33Billing provider info1568983575

33aNPI1568983575

33bProvider type—

28Total paid$1.81M

24GClaims154,159

24DCodes billed47

24AFirst – last monthJan 2018 – Jun 2021

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	33,205	$389K
2019	44,103	$515K
2020	52,083	$610K
2021	24,768	$300K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	57%	14,243	10,740	$1.04M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	25%	17,303	7,818	$450K
J1050	Injection, medroxyprogesterone acetate, 1 mg	5.3%	1,068	1,052	$96K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	2.6%	1,585	932	$47K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	1.7%	782	530	$31K
76817	Ultrasound, pregnant uterus, real time with image documentation, transvaginal	1.6%	553	447	$29K
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	1.3%	1,261	504	$24K
76805	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation	1.1%	218	208	$19K
Q3014	Telehealth originating site facility fee	<1%	1,382	608	$13K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	909	890	$13K
81025		<1%	2,589	1,900	$11K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	933	577	$11K

35 more codes

36415	Collection of venous blood by venipuncture	<1%	5,902	$8K
76830	Ultrasound, transvaginal	<1%	109	$7K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	141	$5K
59430		<1%	150	$5K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	212	$2K
76801		<1%	33	$2K
90834	Psychotherapy session, about 45 minutes	<1%	77	$2K
90715		<1%	68	$1K
99385		<1%	117	$983.60
99401		<1%	92	$853.13
90837	Psychotherapy session, about an hour	<1%	26	$838.95
81003		<1%	621	$683.64
90686		<1%	39	$356.35
H1000	Prenatal care, at-risk assessment	<1%	16	$164.62
G8484	Influenza immunization was not administered, reason not given	0%	6,593	$0.00
G8938	Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible	0%	6,624	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	20,262	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	9,796	$0.00
4004F		0%	7,946	$0.00
G8482	Influenza immunization administered or previously received	0%	362	$0.00
G8483	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	0%	223	$0.00
99203	Doctor's office visit, new patient (routine)	0%	85	$0.00
G8511	Screening for depression documented as positive, follow-up plan not documented, reason not given	0%	14	$0.00
G8428	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	0%	231	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	3,552	$0.00
1036F		0%	12,431	$0.00
G9717	Documentation stating the patient has had a diagnosis of bipolar disorder	0%	2,449	$0.00
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	8,770	$0.00
G9902	Patient screened for tobacco use and identified as a tobacco user	0%	5,310	$0.00
G8432	Depression screening not documented, reason not given	0%	4,027	$0.00
G8510	Screening for depression is documented as negative, a follow-up plan is not required	0%	9,239	$0.00
G9906	Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)	0%	5,135	$0.00
G8433	Screening for depression not completed, documented patient or medical reason	0%	594	$0.00
G8419	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	0%	31	$0.00
3017F		0%	56	$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.