1710318886

1710318886 was paid $732K by Medicaid between Jan 2018 and Sep 2020, across 35 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 36% of everything it billed.

33Billing provider info1710318886

33aNPI1710318886

33bProvider type—

28Total paid$732K

24GClaims17,163

24DCodes billed35

24AFirst – last monthJan 2018 – Sep 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	3,855	$174K
2019	9,009	$367K
2020	4,299	$190K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	36%	3,619	3,221	$261K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	31%	4,395	4,052	$228K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	11%	1,175	1,039	$82K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	8.5%	817	783	$62K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.5%	244	241	$18K
90700		1.5%	963	906	$11K
90670		1.5%	468	446	$11K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	1.2%	738	329	$9K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	1.0%	664	579	$8K
92552		<1%	301	282	$7K
90713		<1%	550	509	$7K
90648		<1%	450	429	$5K

23 more codes

99460		<1%	67	$5K
90680		<1%	155	$3K
99000		<1%	1,081	$2K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	27	$2K
99188		<1%	97	$2K
90707		<1%	77	$1K
90716		<1%	59	$1K
90685		<1%	69	$800.33
85013		<1%	333	$773.13
90651		<1%	18	$759.60
90672		<1%	63	$731.93
99238	Hospital discharge day management, 30 minutes or less	<1%	14	$729.42
90686		<1%	60	$639.85
90744		<1%	54	$636.55
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	40	$505.39
90687		<1%	52	$488.69
81003		<1%	195	$412.67
90633		<1%	28	$365.00
99173		<1%	130	$284.94
99051		<1%	93	$242.89
90688		<1%	22	$206.56
96127		<1%	28	$128.58
36416		<1%	17	$3.18

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.