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NPI 1710940754
NPI deactivated
1710940754
1710940754 was paid $313K by Medicaid between Jan 2018 and Dec 2020, across 44 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 23% of everything it billed.
33Billing provider info1710940754
33aNPI1710940754
33bProvider type—
28Total paid$313K
24GClaims13,617
24DCodes billed44
24AFirst – last monthJan 2018 – Dec 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 | 402 | $11K | |
| 2019 | 933 | $20K | |
| 2020 | 12,282 | $283K |
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 | 23% | 1,486 | 1,393 | $73K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 1,361 | 1,288 | $49K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.2% | 332 | 331 | $26K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 8.1% | 303 | 303 | $26K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.6% | 274 | 272 | $21K |
| 92552 | 6.6% | 877 | 874 | $21K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 4.7% | 288 | 287 | $15K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 4.3% | 173 | 148 | $13K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.1% | 180 | 175 | $13K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.7% | 1,657 | 1,623 | $12K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.8% | 1,171 | 1,158 | $9K |
| 94761 | 2.2% | 2,084 | 1,916 | $7K |
32 more codes
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.0% | 415 | $6K |
| 99050 | 1.7% | 402 | $5K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.4% | 325 | $4K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 128 | $3K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 206 | $3K |
| 99000 | <1% | 269 | $3K | |
| 99381 | <1% | 33 | $2K | |
| 94060 | <1% | 44 | $2K | |
| 94760 | <1% | 334 | $738.53 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 12 | $723.96 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 33 | $435.27 |
| 94150 | <1% | 25 | $266.37 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 36 | $188.50 |
| 81002 | <1% | 33 | $93.44 | |
| 81003 | <1% | 12 | $20.90 | |
| 96160 | <1% | 21 | $17.71 | |
| 90674 | <1% | 106 | $0.84 | |
| 90686 | <1% | 404 | $0.05 | |
| 90710 | 0% | 32 | $0.00 | |
| 90670 | 0% | 131 | $0.00 | |
| 90672 | 0% | 21 | $0.00 | |
| 90633 | 0% | 38 | $0.00 | |
| 90685 | 0% | 58 | $0.00 | |
| 90681 | 0% | 32 | $0.00 | |
| 90648 | 0% | 52 | $0.00 | |
| 90700 | 0% | 12 | $0.00 | |
| 90715 | 0% | 12 | $0.00 | |
| 90734 | 0% | 60 | $0.00 | |
| 90651 | 0% | 74 | $0.00 | |
| 90620 | 0% | 40 | $0.00 | |
| 90723 | 0% | 12 | $0.00 | |
| 90698 | 0% | 19 | $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.