Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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NPI deactivated

1619299500

1619299500 was paid $4.29M by Medicaid between Jan 2018 and Sep 2021, across 41 billing codes. Its largest line is 90935, Hemodialysis procedure with single evaluation by a physician — 39% of everything it billed.

33Billing provider info1619299500
33aNPI1619299500
33bProvider type—
28Total paid$4.29M
24GClaims85,778
24DCodes billed41
24AFirst – last monthJan 2018 – Sep 2021
Box 24A · Dates of service

Paid by month

$0$100K$200K2018201920202021202220232024
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
YearClaimsPaid
201816,228$1.31M
201921,649$1.37M
202029,136$1.13M
202118,765$481K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
90935 Hemodialysis procedure with single evaluation by a physician 39% 11,641 1,018 $1.68M
90999 Dialysis (unlisted procedure)Unlisted dialysis procedure, inpatient or outpatient 29% 15,546 1,435 $1.25M
A4657 Syringe, with or without needle, each 6.9% 15,524 1,481 $295K
J1756 Injection, iron sucrose, 1 mg 3.5% 4,636 1,101 $152K
85018 3.5% 4,741 1,624 $149K
84520 2.2% 2,508 1,584 $95K
83540 1.2% 1,592 1,557 $50K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1.1% 1,590 1,557 $48K
84100 1.1% 1,581 1,253 $48K
87340 1.1% 1,582 1,552 $47K
84450 1.0% 1,379 1,341 $44K
84155 1.0% 1,372 1,341 $44K
29 more codes
84460 1.0% 1,388 $44K
82040 1.0% 1,416 $44K
82310 <1% 1,265 $40K
J0887 Injection, epoetin beta, 1 microgram, (for esrd on dialysis) <1% 974 $36K
82565 <1% 869 $32K
80051 <1% 839 $32K
83550 <1% 778 $28K
83970 <1% 991 $24K
82728 <1% 550 $17K
84466 <1% 687 $17K
83735 <1% 479 $16K
82746 <1% 395 $14K
84075 <1% 267 $10K
82247 <1% 258 $10K
80069 <1% 427 $8K
80053 Comprehensive metabolic panel <1% 160 $4K
86706 <1% 136 $3K
82607 <1% 85 $3K
82108 <1% 94 $3K
85046 <1% 73 $1K
86803 <1% 134 $727.30
G0008 Administration of influenza virus vaccine <1% 63 $681.29
90688 <1% 14 $1.54
86580 0% 14 $0.00
0001A 0% 20 $0.00
90686 0% 24 $0.00
OP250 0% 8,788 $0.00
J1644 Injection, heparin sodium, per 1000 units 0% 882 $0.00
0002A 0% 16 $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.