1700834108

1700834108 was paid $416K by Medicaid between Jan 2018 and Mar 2020, across 25 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 19% of everything it billed.

33Billing provider info1700834108

33aNPI1700834108

33bProvider type—

28Total paid$416K

24GClaims15,560

24DCodes billed25

24AFirst – last monthJan 2018 – Mar 2020

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	6,636	$170K
2019	7,535	$206K
2020	1,389	$40K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	19%	1,896	1,694	$80K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	17%	1,045	998	$71K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	16%	1,006	957	$68K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	15%	1,021	914	$61K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	13%	731	709	$56K
90472	Immunization administration, each additional vaccine (list separately)	8.8%	1,542	1,445	$37K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	6.8%	2,355	2,226	$28K
90658		1.1%	582	568	$4K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	46	41	$3K
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	<1%	27	25	$3K
99462		<1%	39	39	$2K
99460		<1%	27	27	$1K

13 more codes

90733	<1%	166	$287.70
90716	<1%	284	$220.00
90707	<1%	280	$194.52
90700	<1%	950	$65.00
90713	<1%	804	$65.00
90715	<1%	58	$13.70
90680	<1%	551	$13.70
90633	0%	286	$0.00
90670	0%	732	$0.00
90649	0%	428	$0.00
90648	0%	26	$0.00
90748	0%	559	$0.00
90657	0%	119	$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.