1619925633

1619925633 was paid $484K by Medicaid between Jan 2018 and Dec 2020, across 27 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 28% of everything it billed.

33Billing provider info1619925633

33aNPI1619925633

33bProvider type—

28Total paid$484K

24GClaims19,372

24DCodes billed27

24AFirst – last monthJan 2018 – Dec 2020

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	6,509	$180K
2019	7,053	$169K
2020	5,810	$135K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	28%	2,294	2,103	$138K
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	24%	1,323	1,233	$119K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	7.4%	1,695	1,678	$36K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	6.4%	371	371	$31K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	4.4%	229	229	$21K
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	2.9%	839	788	$14K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	2.9%	1,524	1,520	$14K
87502	Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets	2.8%	174	157	$13K
96127		2.8%	1,231	1,207	$13K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	2.7%	1,537	1,433	$13K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	2.7%	965	906	$13K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	2.2%	128	128	$11K

15 more codes

90472	Immunization administration, each additional vaccine (list separately)	1.8%	589	$9K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	1.5%	258	$7K
A4258	Spring-powered device for lancet, each	1.2%	1,520	$6K
36416		1.2%	597	$6K
87081		1.1%	778	$5K
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	365	$4K
92550		<1%	170	$3K
94760		<1%	969	$2K
87070		<1%	98	$2K
A7004	Small volume nonfiltered pneumatic nebulizer, disposable	<1%	894	$1K
92552		<1%	64	$1K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	13	$1K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	12	$412.20
J7614	Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg	<1%	235	$327.39
J7620	Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	<1%	500	$189.80

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.