1730442153

1730442153 was paid $3.91M by Medicaid between Jan 2018 and Apr 2022, across 56 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 72% of everything it billed.

33Billing provider info1730442153

33aNPI1730442153

33bProvider type—

28Total paid$3.91M

24GClaims152,569

24DCodes billed56

24AFirst – last monthJan 2018 – Apr 2022

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	46,906	$873K
2019	37,078	$871K
2020	31,919	$894K
2021	31,398	$1.02M
2022	5,268	$245K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	72%	33,166	24,628	$2.81M
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%	37,517	22,321	$749K
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	2.2%	4,235	2,434	$88K
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	1.5%	2,098	1,395	$59K
G0467	Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	1.2%	1,470	1,222	$46K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	2,984	1,857	$28K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	1,093	678	$27K
90686		<1%	2,004	1,194	$19K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	1,400	845	$17K
83036	Hemoglobin; glycosylated (A1C)	<1%	3,647	2,337	$15K
99442		<1%	1,155	607	$11K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	1,260	741	$9K

44 more codes

99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	297	$8K
99441		<1%	833	$4K
D7140	Extraction, erupted tooth or exposed root	<1%	39	$2K
99204	Doctor's office visit, new patient (more involved)	<1%	62	$2K
90715		<1%	155	$2K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	77	$2K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	<1%	48	$1K
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	<1%	58	$1K
97810		<1%	87	$1K
90834	Psychotherapy session, about 45 minutes	<1%	30	$804.68
99443		<1%	48	$440.77
82962		<1%	350	$376.98
99385		<1%	17	$368.40
80305		<1%	69	$284.33
90472	Immunization administration, each additional vaccine (list separately)	<1%	16	$109.93
81002		<1%	40	$20.50
3046F		0%	2,209	$0.00
4004F		0%	11,706	$0.00
3045F		0%	654	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	2,908	$0.00
G8753	Most recent systolic blood pressure >= 140 mmhg	0%	2,673	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	0%	5,958	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	133	$0.00
G8598	Aspirin or another antiplatelet therapy used	0%	369	$0.00
G8484	Influenza immunization was not administered, reason not given	0%	225	$0.00
3051F		0%	128	$0.00
G8482	Influenza immunization administered or previously received	0%	107	$0.00
85610		0%	29	$0.00
3044F		0%	841	$0.00
1036F		0%	13,768	$0.00
G8428	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	0%	145	$0.00
G8756	No documentation of blood pressure measurement, reason not given	0%	872	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	6,907	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	678	$0.00
G8419	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	0%	2,054	$0.00
G8755	Most recent diastolic blood pressure >= 90 mmhg	0%	1,773	$0.00
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	0%	55	$0.00
D1351	Sealant - per tooth	0%	1,525	$0.00
3017F		0%	1,543	$0.00
G9902	Patient screened for tobacco use and identified as a tobacco user	0%	148	$0.00
3014F		0%	594	$0.00
G0008	Administration of influenza virus vaccine	0%	16	$0.00
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	156	$0.00
G9906	Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)	0%	140	$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.