1689382400

1689382400 was paid $41.22 by Medicaid between Mar 2023 and Jul 2023, across 12 billing codes. Its largest line is 90715, — 100% of everything it billed.

33Billing provider info1689382400

33aNPI1689382400

33bProvider type—

28Total paid$41.22

24GClaims1,189

24DCodes billed12

24AFirst – last monthMar 2023 – Jul 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
2023	1,189	$41.22

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90715		100%	43	43	$41.22
G9226	Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)	0%	16	16	$0.00
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	0%	724	628	$0.00
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	0%	13	13	$0.00
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	0%	188	171	$0.00
85018		0%	13	12	$0.00
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	0%	48	48	$0.00
81003		0%	31	30	$0.00
81025		0%	15	15	$0.00
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	0%	41	41	$0.00
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	0%	25	25	$0.00
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	0%	32	32	$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.