Home ›
NPI 1679579809
NPI deactivated
1679579809
1679579809 was paid $32K by Medicaid between Jan 2018 and May 2023, across 24 billing codes. Its largest line is 99394, Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) — 22% of everything it billed.
33Billing provider info1679579809
33aNPI1679579809
33bProvider type—
28Total paid$32K
24GClaims10,469
24DCodes billed24
24AFirst – last monthJan 2018 – May 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 | 3,638 | $17K | |
| 2019 | 3,630 | $13K | |
| 2020 | 1,160 | $2K | |
| 2021 | 874 | $506.30 | |
| 2022 | 990 | $603.62 | |
| 2023 | 177 | $220.72 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 22% | 715 | 704 | $7K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 20% | 516 | 511 | $6K |
| 92552 | 11% | 385 | 380 | $4K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 10% | 1,606 | 1,558 | $3K |
| 87110 | 7.2% | 152 | 151 | $2K | |
| 82947 | 4.2% | 386 | 382 | $1K | |
| 82465 | 3.9% | 370 | 367 | $1K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.7% | 2,549 | 2,408 | $1K |
| 99173 | 2.8% | 359 | 356 | $904.80 | |
| 81003 | 2.6% | 351 | 351 | $832.30 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.6% | 263 | 255 | $832.24 |
| 83026 | 2.6% | 326 | 326 | $826.22 |
12 more codes
| 86580 | 1.8% | 324 | $589.79 | |
| 86592 | 1.5% | 144 | $490.24 | |
| 92551 | 1.3% | 268 | $434.18 | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 216 | $264.40 |
| 90686 | <1% | 964 | $173.08 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 14 | $105.08 |
| 85018 | <1% | 49 | $81.00 | |
| 85014 | <1% | 50 | $59.83 | |
| 90734 | <1% | 216 | $45.24 | |
| 90651 | <1% | 172 | $45.12 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 56 | $44.80 |
| 90672 | <1% | 18 | $0.02 |
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.