ANTIETAM PEDIATRIC AND ADOLESCENT CARE, LLC
NPI: 1780627810
· HAGERSTOWN, MD 21740
· 2080A0000X
$131K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
528 |
$13K |
| 2019 |
550 |
$13K |
| 2020 |
392 |
$11K |
| 2021 |
545 |
$14K |
| 2022 |
694 |
$28K |
| 2023 |
657 |
$22K |
| 2024 |
668 |
$29K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
|
3,429 |
3,358 |
$84K |
| 99213 |
|
399 |
351 |
$35K |
| 99214 |
|
76 |
62 |
$10K |
| 90686 |
|
52 |
36 |
$989.61 |
| G2211 |
Complex e/m visit add on |
21 |
19 |
$353.01 |
| 96127 |
|
13 |
13 |
$61.23 |
| 1160F |
|
22 |
17 |
$0.00 |
| 1159F |
|
22 |
17 |
$0.00 |