1659331866

1659331866 was paid $74K by Medicaid between Jan 2018 and Mar 2019, across 6 billing codes. Its largest line is X4011, State-specific procedure code — 53% of everything it billed.

33Billing provider info1659331866

33aNPI1659331866

33bProvider type—

28Total paid$74K

24GClaims470

24DCodes billed6

24AFirst – last monthJan 2018 – Mar 2019

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	315	$37K
2019	155	$36K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
X4011	State-specific procedure code	53%	80	79	$39K
Y7506		22%	38	38	$16K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	17%	161	88	$12K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	4.5%	134	131	$3K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	2.7%	14	12	$2K
87081		<1%	43	43	$363.05

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.