Kaplan, Seth

Kaplan, Seth was paid $10K by Medicaid between Sep 2021 and Jul 2022, across 7 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 42% of everything it billed.

33Billing provider infoKAPLAN, SETH
FRISCO, TX 75033

33aNPI1730186925assigned 07/01/2005

33bProvider typePediatrics Physician

28Total paid$10K

24GClaims431

24DCodes billed7

24AFirst – last monthSep 2021 – Jul 2022

Compared with peers

Next to other Pediatrics Physician providers in Texas

Rank by total paid#925 of 1,136

Median peer was paid$329K

This provider vs. median0.0×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

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
2021	143	$6K
2022	288	$5K

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	42%	83	76	$4K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	20%	27	27	$2K
90460	Immunization administration through 18 years of age via any route, first or only component	16%	237	87	$2K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	11%	14	14	$1K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	9.9%	33	30	$1K
96110	Developmental screening, with scoring and documentation, per standardized instrument	1.3%	17	14	$130.24
90686		0%	20	18	$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.