1902070915

1902070915 was paid $72K by Medicaid between Jan 2018 and Dec 2019, across 8 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 71% of everything it billed.

33Billing provider info1902070915

33aNPI1902070915

33bProvider type—

28Total paid$72K

24GClaims2,029

24DCodes billed8

24AFirst – last monthJan 2018 – Dec 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	1,105	$38K
2019	924	$34K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	71%	1,330	927	$52K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	18%	197	184	$13K
D1206	Topical application of fluoride varnish	4.3%	166	166	$3K
92551		2.8%	194	194	$2K
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	1.9%	14	12	$1K
99201		<1%	19	19	$717.48
99411		<1%	24	24	$354.96
99173		<1%	85	85	$209.16

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.