1639180581

1639180581 was paid $151K by Medicaid between Jan 2018 and Dec 2018, across 32 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 33% of everything it billed.

33Billing provider info1639180581

33aNPI1639180581

33bProvider type—

28Total paid$151K

24GClaims4,981

24DCodes billed32

24AFirst – last monthJan 2018 – Dec 2018

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	4,981	$151K

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	33%	1,074	991	$50K
D1206	Topical application of fluoride varnish	11%	309	307	$16K
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	9.3%	208	199	$14K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	8.9%	194	194	$13K
90460	Immunization administration through 18 years of age via any route, first or only component	6.9%	369	328	$10K
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	5.3%	246	228	$8K
92015	Determination of refractive state	5.1%	143	143	$8K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	4.7%	94	94	$7K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	2.5%	57	57	$4K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	2.2%	245	240	$3K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	2.2%	119	115	$3K
99401		2.0%	123	123	$3K

20 more codes

99188		1.1%	133	$2K
92567		<1%	155	$1K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	44	$1K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	<1%	18	$1K
92587		<1%	108	$1K
87999		<1%	263	$904.20
99177		<1%	85	$868.00
99058		<1%	48	$770.85
96127		<1%	126	$478.39
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	33	$219.20
90651		<1%	13	$208.85
83655		<1%	14	$166.82
36416		<1%	89	$119.60
85018		<1%	29	$68.40
A7003	Administration set, with small volume nonfiltered pneumatic nebulizer, disposable	<1%	28	$65.76
S9470	Nutritional counseling, dietitian visit	0%	232	$0.00
99051		0%	19	$0.00
S9451	Exercise classes, non-physician provider, per session	0%	233	$0.00
90686		0%	39	$0.00
90688		0%	91	$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.