Home ›
NPI 1629498498
NPI deactivated
1629498498
1629498498 was paid $7.78M by Medicaid between Mar 2018 and Jun 2024, across 138 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 18% of everything it billed.
33Billing provider info1629498498
33aNPI1629498498
33bProvider type—
28Total paid$7.78M
24GClaims479,501
24DCodes billed138
24AFirst – last monthMar 2018 – Jun 2024
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 | 16 | $0.00 | |
| 2019 | 17,397 | $207K | |
| 2020 | 72,840 | $1.46M | |
| 2021 | 128,877 | $3.33M | |
| 2022 | 107,807 | $2.02M | |
| 2023 | 115,066 | $581K | |
| 2024incomplete | 37,498 | $183K |
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 | 18% | 73,248 | 68,590 | $1.40M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 11% | 16,299 | 16,082 | $859K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.1% | 13,730 | 13,560 | $711K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.7% | 10,251 | 10,020 | $525K |
| D0145 | Oral evaluation for a patient under three years of age | 5.7% | 3,350 | 3,296 | $441K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.9% | 6,738 | 6,648 | $378K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.1% | 77,571 | 32,926 | $321K |
| 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 | 2.9% | 12,629 | 12,113 | $228K |
| S0620 | Routine ophthalmological examination including refraction; new patient | 2.5% | 4,649 | 4,542 | $194K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 2.4% | 3,557 | 3,361 | $186K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.2% | 5,244 | 5,091 | $168K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 2.1% | 4,295 | 3,582 | $164K |
126 more codes
| S0621 | Routine ophthalmological examination including refraction; established patient | 1.9% | 3,471 | $146K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.8% | 8,502 | $143K |
| 90791 | Psychiatric diagnostic evaluation | 1.8% | 2,847 | $142K |
| D0120 | Dental checkup, returning patient | 1.7% | 5,199 | $134K |
| 90461 | 1.5% | 19,780 | $117K | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 1.3% | 740 | $98K |
| 76819 | Fetal biophysical profile; without non-stress testing | 1.1% | 1,313 | $87K |
| D0272 | Bitewings - two radiographic images | 1.0% | 3,826 | $78K |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 1,069 | $75K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 18,374 | $73K |
| D1206 | Topical application of fluoride varnish | <1% | 5,458 | $71K |
| V2020 | Frames, purchases | <1% | 4,841 | $67K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | <1% | 5,976 | $64K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 513 | $57K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 5,200 | $56K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 10,457 | $52K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 2,956 | $51K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 570 | $50K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 5,067 | $50K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 5,008 | $47K |
| 59430 | <1% | 550 | $45K | |
| D1351 | Sealant - per tooth | <1% | 1,393 | $33K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,124 | $32K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 527 | $32K |
| D1110 | Prophylaxis - adult | <1% | 625 | $31K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 352 | $26K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 317 | $23K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 3,156 | $23K |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | <1% | 2,108 | $20K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 3,976 | $18K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 39 | $17K |
| 92523 | <1% | 269 | $17K | |
| D0274 | Bitewings - four radiographic images | <1% | 604 | $16K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | <1% | 634 | $15K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 447 | $14K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 464 | $14K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 1,426 | $14K |
| 59025 | Fetal non-stress test | <1% | 816 | $11K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 3,252 | $11K |
| 84703 | <1% | 3,288 | $10K | |
| 76801 | <1% | 252 | $9K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 308 | $9K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 682 | $9K |
| 90837 | Psychotherapy session, about an hour | <1% | 347 | $9K |
| 99381 | <1% | 100 | $8K | |
| 80061 | Lipid panel | <1% | 3,613 | $8K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 3,493 | $8K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 135 | $7K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 717 | $6K |
| D0330 | Panoramic radiographic image | <1% | 176 | $6K |
| 99205 | Prolong outpt/office vis | <1% | 133 | $5K |
| 76820 | <1% | 202 | $5K | |
| 90620 | <1% | 102 | $5K | |
| 76830 | Ultrasound, transvaginal | <1% | 84 | $5K |
| 82947 | <1% | 5,922 | $4K | |
| 81002 | <1% | 1,445 | $3K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 35 | $2K |
| D0170 | <1% | 176 | $2K | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 223 | $2K |
| 90715 | <1% | 461 | $2K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,969 | $2K |
| 84460 | <1% | 2,807 | $2K | |
| 84450 | <1% | 2,807 | $2K | |
| V2105 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens | <1% | 93 | $2K |
| V2025 | Deluxe frame | <1% | 100 | $2K |
| 76821 | <1% | 27 | $1K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 14 | $1K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 14 | $1K |
| 90734 | <1% | 345 | $830.10 | |
| 96158 | <1% | 156 | $806.12 | |
| 90474 | <1% | 83 | $781.03 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 14 | $624.98 |
| 90686 | <1% | 17,502 | $594.42 | |
| V2107 | Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens | <1% | 42 | $435.96 |
| 90651 | <1% | 2,227 | $308.46 | |
| 99241 | <1% | 13 | $247.00 | |
| D0140 | Limited oral evaluation - problem focused | <1% | 12 | $225.36 |
| 81025 | <1% | 30 | $214.08 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 14 | $188.39 |
| 92587 | <1% | 65 | $92.62 | |
| 90688 | <1% | 1,594 | $21.75 | |
| 0001A | <1% | 2,057 | $18.76 | |
| 85018 | <1% | 74 | $17.08 | |
| 87999 | <1% | 353 | $3.17 | |
| 90619 | <1% | 374 | $0.04 | |
| 90670 | <1% | 8,482 | $0.01 | |
| 90723 | 0% | 1,518 | $0.00 | |
| 96127 | 0% | 14,822 | $0.00 | |
| 96040 | 0% | 134 | $0.00 | |
| 90696 | 0% | 337 | $0.00 | |
| D0603 | 0% | 8,391 | $0.00 | |
| 96161 | 0% | 2,001 | $0.00 | |
| 90680 | 0% | 4,749 | $0.00 | |
| 82962 | 0% | 585 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 2,790 | $0.00 |
| 90698 | 0% | 171 | $0.00 | |
| 97802 | 0% | 659 | $0.00 | |
| 90697 | 0% | 1,255 | $0.00 | |
| 90677 | 0% | 1,089 | $0.00 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 0% | 365 | $0.00 |
| D0602 | 0% | 1,392 | $0.00 | |
| 90480 | 0% | 168 | $0.00 | |
| 90716 | 0% | 203 | $0.00 | |
| 0081A | 0% | 59 | $0.00 | |
| 36416 | 0% | 170 | $0.00 | |
| 91315 | 0% | 15 | $0.00 | |
| 0082A | 0% | 32 | $0.00 | |
| 0074A | 0% | 47 | $0.00 | |
| 91307 | 0% | 63 | $0.00 | |
| 90656 | 0% | 50 | $0.00 | |
| 0072A | 0% | 14 | $0.00 | |
| 90685 | 0% | 1,073 | $0.00 | |
| 90846 | Family psychotherapy without the patient present, 50 minutes | 0% | 13 | $0.00 |
| 90707 | 0% | 198 | $0.00 | |
| 90633 | 0% | 3,216 | $0.00 | |
| 90648 | 0% | 4,133 | $0.00 | |
| 90710 | 0% | 353 | $0.00 | |
| 90700 | 0% | 143 | $0.00 | |
| 97803 | 0% | 904 | $0.00 | |
| 87420 | 0% | 29 | $0.00 | |
| 91300 | 0% | 112 | $0.00 | |
| 0054A | 0% | 38 | $0.00 | |
| 0071A | 0% | 30 | $0.00 | |
| 91308 | 0% | 108 | $0.00 | |
| 90687 | 0% | 73 | $0.00 | |
| 91312 | 0% | 30 | $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.