1902169329

1902169329 was paid $8.20M by Medicaid between Jan 2018 and Apr 2022, across 70 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 66% of everything it billed.

33Billing provider info1902169329

33aNPI1902169329

33bProvider type—

28Total paid$8.20M

24GClaims305,628

24DCodes billed70

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	121,504	$2.55M
2019	78,044	$2.04M
2020	48,052	$1.60M
2021	49,420	$1.64M
2022	8,608	$370K

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	66%	64,533	42,952	$5.37M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	17%	60,113	33,264	$1.43M
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	6.8%	25,774	12,014	$561K
90460	Immunization administration through 18 years of age via any route, first or only component	2.1%	21,585	5,727	$170K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	1.7%	5,664	3,565	$143K
J1050	Injection, medroxyprogesterone acetate, 1 mg	1.5%	2,589	1,538	$124K
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	1.4%	5,588	3,279	$111K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	1.2%	3,365	2,310	$95K
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%	1,324	1,192	$31K
99381		<1%	1,303	804	$31K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	3,909	2,354	$29K
80305		<1%	5,127	3,340	$19K

58 more codes

81025		<1%	4,875	$16K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	1,359	$10K
90474		<1%	1,660	$8K
T2003	Non-emergency transportation, per trip	<1%	1,149	$6K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	340	$5K
90686		<1%	2,526	$4K
92551		<1%	1,180	$3K
87210		<1%	1,694	$3K
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	<1%	139	$3K
85018		<1%	2,683	$3K
D1208	Topical application of fluoride, excluding varnish	<1%	490	$3K
59430		<1%	67	$3K
99401		<1%	147	$2K
81002		<1%	2,516	$2K
90715		<1%	365	$2K
81003		<1%	1,545	$1K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	92	$1K
H1000	Prenatal care, at-risk assessment	<1%	12	$994.50
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	98	$928.74
99441		<1%	201	$761.60
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	<1%	186	$733.28
90670		<1%	3,758	$713.92
90834	Psychotherapy session, about 45 minutes	<1%	27	$704.22
99173		<1%	418	$405.30
90698		<1%	2,080	$381.50
90744		<1%	1,100	$367.85
90716		<1%	516	$287.28
90681		<1%	1,967	$237.25
90633		<1%	709	$98.75
90707		<1%	539	$65.00
36416		<1%	472	$63.01
90700		<1%	203	$30.00
90634		<1%	104	$25.00
90648		<1%	1,474	$10.00
4004F		0%	7,564	$0.00
G8938	Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible	0%	3,372	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	7,059	$0.00
3046F		0%	24	$0.00
99204	Doctor's office visit, new patient (more involved)	0%	13	$0.00
G8484	Influenza immunization was not administered, reason not given	0%	442	$0.00
G8482	Influenza immunization administered or previously received	0%	195	$0.00
99203	Doctor's office visit, new patient (routine)	0%	29	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	0%	20	$0.00
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	0%	37	$0.00
90461		0%	16	$0.00
1036F		0%	43,452	$0.00
G8419	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	0%	2,342	$0.00
90688		0%	75	$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%	18	$0.00
90723		0%	1,052	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	1,184	$0.00
G9231	Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period	0%	541	$0.00
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	188	$0.00
G8428	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	0%	347	$0.00
82962		0%	27	$0.00
G9902	Patient screened for tobacco use and identified as a tobacco user	0%	18	$0.00
90674		0%	29	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	19	$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.