1871503235

1871503235 was paid $1.22M by Medicaid between Mar 2018 and Sep 2020, across 14 billing codes. Its largest line is 90791, psychiatric diagnostic evaluation — 33% of everything it billed.

33Billing provider info1871503235

33aNPI1871503235

33bProvider type—

28Total paid$1.22M

24GClaims6,853

24DCodes billed14

24AFirst – last monthMar 2018 – Sep 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	2,718	$205K
2019	1,079	$288K
2020	3,056	$731K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90791	Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation	33%	4,559	3,108	$401K
L0700	Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)	30%	346	339	$363K
L0631	Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	19%	351	344	$233K
E0855	Cervical traction equipment not requiring additional stand or frame	13%	384	376	$157K
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	3.9%	936	542	$48K
90792	Psychiatric diagnostic evaluation with medical services	<1%	79	78	$9K
E0731	Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric)	<1%	27	26	$5K
E0570	Nebulizer, with compressor	<1%	27	26	$3K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	<1%	28	27	$2K
E0550	Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery	<1%	27	26	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	48	42	$1K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	<1%	12	12	$909.60

2 more codes

E0221	Infrared heating pad system	<1%	12	$40.00
94760		0%	17	$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.