1912091497

1912091497 was paid $2.53M by Medicaid between Jan 2018 and Sep 2021, across 30 billing codes. Its largest line is 90999, dialysis (unlisted procedure) — 88% of everything it billed.

33Billing provider info1912091497

33aNPI1912091497

33bProvider type—

28Total paid$2.53M

24GClaims90,829

24DCodes billed30

24AFirst – last monthJan 2018 – Sep 2021

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	28,046	$876K
2019	27,313	$757K
2020	29,982	$713K
2021	5,488	$188K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90999	Dialysis (unlisted procedure)Unlisted dialysis procedure, inpatient or outpatient	88%	23,289	2,058	$2.24M
J0887	Injection, epoetin beta, 1 microgram, (for esrd on dialysis)	5.4%	1,899	945	$137K
J0882	Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)	4.8%	2,614	525	$122K
J2501	Injection, paricalcitol, 1 mcg	<1%	15,789	1,644	$19K
J2916	Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg	<1%	2,766	915	$16K
A4657	Syringe, with or without needle, each	<1%	19,320	1,795	$2K
90686		<1%	82	72	$478.50
J7030	Infusion, normal saline solution , 1000 cc	<1%	9,534	884	$65.00
82310		<1%	507	390	$37.80
82108		<1%	60	57	$26.67
82040		<1%	413	389	$15.54
82374		<1%	376	330	$15.36

18 more codes

82435		<1%	376	$14.43
84295		<1%	373	$10.08
85045		<1%	410	$8.36
82565		<1%	293	$5.36
84100		<1%	286	$4.96
84132		<1%	322	$4.81
83970		<1%	423	$0.22
84466		<1%	393	$0.16
82728		<1%	390	$0.08
83540		<1%	392	$0.06
87340		<1%	106	$0.05
86706		<1%	107	$0.04
84075		0%	269	$0.00
84540		0%	983	$0.00
G0008	Administration of influenza virus vaccine	0%	60	$0.00
83550		0%	164	$0.00
84155		0%	269	$0.00
J1644	Injection, heparin sodium, per 1000 units	0%	8,564	$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.