Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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NPI deactivated

1700120318

1700120318 was paid $414K by Medicaid between Jan 2018 and Jan 2021, across 67 billing codes. Its largest line is 87633, Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets — 29% of everything it billed.

33Billing provider info1700120318
33aNPI1700120318
33bProvider type—
28Total paid$414K
24GClaims35,632
24DCodes billed67
24AFirst – last monthJan 2018 – Jan 2021
Box 24A · Dates of service

Paid by month

$0$20K$40K$60K2018201920202021202220232024
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
YearClaimsPaid
201812,795$69K
201910,412$95K
202012,009$249K
2021416$918.09
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 29% 1,492 1,416 $119K
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 21% 1,191 940 $88K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 5.5% 1,495 1,418 $23K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 4.9% 1,176 930 $20K
87581 4.7% 1,498 1,422 $20K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 4.1% 435 435 $17K
87486 3.1% 1,497 1,421 $13K
G0482 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed 2.6% 161 159 $11K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 2.5% 2,130 2,052 $10K
80074 2.2% 430 427 $9K
86001 1.5% 137 132 $6K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1.3% 1,117 1,082 $6K
55 more codes
84443 Thyroid stimulating hormone (TSH) 1.3% 1,666 $5K
86003 1.2% 149 $5K
80061 Lipid panel 1.2% 1,740 $5K
80053 Comprehensive metabolic panel 1.2% 1,956 $5K
86038 <1% 440 $4K
83036 Hemoglobin; glycosylated (A1C) <1% 1,551 $4K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 223 $3K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 223 $3K
82607 <1% 1,013 $3K
84481 <1% 495 $3K
83935 <1% 411 $3K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 167 $2K
84439 <1% 535 $2K
99000 <1% 940 $2K
82746 <1% 680 $2K
82728 <1% 637 $2K
84153 <1% 555 $2K
86677 <1% 431 $2K
83540 <1% 624 $2K
81002 <1% 1,259 $1K
86592 <1% 405 $1K
86701 <1% 157 $1K
84550 <1% 756 $1K
86063 <1% 417 $1K
84466 <1% 297 $958.04
82043 <1% 531 $755.07
85651 <1% 457 $716.70
P9603 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled <1% 302 $697.20
86430 <1% 429 $616.24
84480 <1% 374 $584.47
86140 <1% 452 $570.10
0100U <1% 14 $500.00
84436 <1% 349 $455.90
83550 <1% 188 $354.64
36415 Collection of venous blood by venipuncture <1% 1,046 $342.53
82670 <1% 111 $245.85
80164 <1% 61 $215.71
84479 <1% 240 $205.14
84144 <1% 71 $90.60
84402 <1% 14 $68.04
83001 <1% 71 $65.00
83002 <1% 71 $64.88
80076 <1% 74 $31.66
84146 <1% 58 $17.11
83735 <1% 13 $5.42
87507 0% 26 $0.00
86704 0% 25 $0.00
81226 0% 36 $0.00
87340 0% 14 $0.00
86706 0% 13 $0.00
81015 0% 28 $0.00
81225 0% 36 $0.00
86803 0% 16 $0.00
86708 0% 13 $0.00
83970 0% 13 $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.