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NPI 1750688479
NPI deactivated
1750688479
1750688479 was paid $1.08M by Medicaid between Jan 2018 and Sep 2019, across 45 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 28% of everything it billed.
33Billing provider info1750688479
33aNPI1750688479
33bProvider type—
28Total paid$1.08M
24GClaims50,417
24DCodes billed45
24AFirst – last monthJan 2018 – Sep 2019
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 | 31,299 | $661K | |
| 2019 | 19,118 | $421K |
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 | 28% | 4,371 | 3,625 | $300K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 5,832 | 4,917 | $277K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.5% | 1,108 | 922 | $81K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.7% | 830 | 729 | $61K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.4% | 729 | 581 | $58K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.7% | 740 | 664 | $50K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.5% | 3,362 | 1,441 | $38K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.3% | 5,740 | 4,701 | $35K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.9% | 2,246 | 1,923 | $31K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.5% | 2,660 | 2,297 | $27K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.5% | 1,537 | 1,278 | $27K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.1% | 1,475 | 1,175 | $23K |
33 more codes
| 99215 | Doctor's office visit, returning patient (complex) | 1.4% | 144 | $15K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.2% | 936 | $13K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,553 | $9K |
| 99173 | <1% | 1,734 | $7K | |
| 92558 | <1% | 2,043 | $6K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 540 | $6K |
| 81003 | <1% | 1,802 | $3K | |
| 90474 | <1% | 338 | $3K | |
| 1111F | <1% | 787 | $2K | |
| 81001 | <1% | 397 | $1K | |
| 99460 | <1% | 34 | $1K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 18 | $942.84 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 295 | $938.62 |
| 80053 | Comprehensive metabolic panel | <1% | 338 | $900.27 |
| 90651 | <1% | 366 | $684.01 | |
| 3008F | <1% | 385 | $440.00 | |
| 73562 | <1% | 86 | $433.68 | |
| 72100 | <1% | 46 | $330.66 | |
| 90734 | <1% | 231 | $309.70 | |
| 90620 | <1% | 123 | $198.75 | |
| 90715 | <1% | 91 | $105.76 | |
| 90633 | <1% | 203 | $84.84 | |
| 73030 | <1% | 15 | $70.67 | |
| 90686 | <1% | 452 | $67.83 | |
| 80061 | Lipid panel | <1% | 30 | $57.25 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 26 | $42.63 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 15 | $8.41 |
| 90670 | 0% | 624 | $0.00 | |
| 90707 | 0% | 97 | $0.00 | |
| 90744 | 0% | 184 | $0.00 | |
| 90698 | 0% | 411 | $0.00 | |
| 90680 | 0% | 354 | $0.00 | |
| 90716 | 0% | 89 | $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.