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NPI 1639484793
NPI deactivated
1639484793
1639484793 was paid $1.42M by Medicaid between Jan 2018 and Sep 2023, across 49 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 20% of everything it billed.
33Billing provider info1639484793
33aNPI1639484793
33bProvider type—
28Total paid$1.42M
24GClaims71,754
24DCodes billed49
24AFirst – last monthJan 2018 – Sep 2023
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 | 10,019 | $295K | |
| 2019 | 8,981 | $305K | |
| 2020 | 7,179 | $261K | |
| 2021 | 16,691 | $374K | |
| 2022 | 19,120 | $156K | |
| 2023 | 9,764 | $25K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 20% | 3,334 | 3,010 | $290K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 11% | 1,885 | 1,735 | $156K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 11% | 1,896 | 1,744 | $155K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 3,361 | 3,017 | $150K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 10% | 1,661 | 1,561 | $145K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 10% | 2,323 | 2,084 | $144K |
| 99199 | Unlisted special service, procedure or report | 7.3% | 31,879 | 31,116 | $104K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.5% | 528 | 493 | $49K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.6% | 1,097 | 1,033 | $37K |
| D0145 | Oral evaluation for a patient under three years of age | 2.5% | 1,074 | 1,000 | $35K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.4% | 1,841 | 1,749 | $34K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.1% | 585 | 461 | $30K |
37 more codes
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.9% | 2,862 | $27K |
| D1206 | Topical application of fluoride varnish | 1.1% | 1,074 | $16K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1.0% | 677 | $14K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 566 | $8K |
| 90461 | <1% | 1,868 | $5K | |
| 90474 | <1% | 235 | $4K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 122 | $4K |
| 83655 | <1% | 240 | $1K | |
| 99442 | <1% | 17 | $819.06 | |
| 81003 | <1% | 454 | $599.21 | |
| 97802 | <1% | 23 | $597.62 | |
| 85018 | <1% | 1,778 | $571.14 | |
| 90686 | <1% | 1,187 | $475.55 | |
| 92551 | <1% | 1,032 | $427.70 | |
| 99173 | <1% | 2,637 | $372.60 | |
| 90734 | <1% | 70 | $263.96 | |
| 90651 | <1% | 83 | $245.70 | |
| 90670 | <1% | 1,595 | $217.66 | |
| 96127 | <1% | 51 | $153.00 | |
| 96161 | <1% | 38 | $149.34 | |
| 92552 | <1% | 357 | $65.60 | |
| 90715 | <1% | 14 | $38.93 | |
| 90633 | <1% | 308 | $36.61 | |
| 36416 | <1% | 39 | $3.22 | |
| 90744 | 0% | 474 | $0.00 | |
| 90680 | 0% | 611 | $0.00 | |
| 90723 | 0% | 270 | $0.00 | |
| 90698 | 0% | 1,042 | $0.00 | |
| 90647 | 0% | 262 | $0.00 | |
| 90634 | 0% | 22 | $0.00 | |
| 90716 | 0% | 14 | $0.00 | |
| 90696 | 0% | 31 | $0.00 | |
| 90681 | 0% | 67 | $0.00 | |
| 90700 | 0% | 42 | $0.00 | |
| 90685 | 0% | 68 | $0.00 | |
| 90710 | 0% | 46 | $0.00 | |
| 90707 | 0% | 14 | $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.