Managed care
Zmily Health Group INC.
Zmily Health Group INC. was paid $340K by Medicaid between Jan 2019 and Nov 2024, across 23 billing codes. Its largest line is 99454, — 29% of everything it billed.
33Billing provider infoZMILY HEALTH GROUP INC.
DENVER, CO 80222
DENVER, CO 80222
33aNPI1689050841assigned 08/10/2015
33bProvider typeHealth Maintenance Organization
28Total paid$340K
24GClaims23,020
24DCodes billed23
24AFirst – last monthJan 2019 – Nov 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 | |
|---|---|---|---|
| 2019 | 4,217 | $105K | |
| 2020 | 3,266 | $42K | |
| 2021 | 5,346 | $72K | |
| 2022 | 4,882 | $61K | |
| 2023 | 4,196 | $46K | |
| 2024incomplete | 1,113 | $14K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99454 | 29% | 7,191 | 7,082 | $98K | |
| 99457 | 24% | 7,260 | 7,034 | $80K | |
| 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% | 1,622 | 1,356 | $67K |
| 99490 | Ccm add 20min | 13% | 3,409 | 3,389 | $46K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 4.9% | 177 | 170 | $17K |
| 99401 | 4.6% | 694 | 576 | $16K | |
| 99458 | 2.2% | 760 | 750 | $7K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.1% | 55 | 51 | $4K |
| 99497 | <1% | 169 | 156 | $1K | |
| 99407 | <1% | 164 | 137 | $815.98 | |
| 99453 | <1% | 98 | 98 | $811.44 | |
| 99402 | <1% | 443 | 381 | $790.72 |
11 more codes
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 49 | $720.02 |
| 90674 | <1% | 26 | $364.58 | |
| 99487 | Ccm add 20min | <1% | 12 | $206.80 |
| 90756 | <1% | 14 | $164.16 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 320 | $90.14 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 13 | $77.84 |
| 36415 | Collection of venous blood by venipuncture | <1% | 401 | $53.67 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 30 | $15.54 |
| 93000 | <1% | 24 | $7.00 | |
| 99383 | 0% | 15 | $0.00 | |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 0% | 74 | $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.
From NPPES
Who's on the registration
Authorized officialZMILY, MISBAH (CEO)
| Provider | Location | Paid |
|---|---|---|
| LA Familia Primary Care P C | Raton, NM | $1.73M |
| Premier Family Medicine LLC | Denver, CO | $705K |
| Zia Healthcare Services LLC | Raton, NM | $34K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.