1952529315

1952529315 was paid $304K by Medicaid between Jan 2018 and Sep 2022, across 16 billing codes. Its largest line is 96127, — 33% of everything it billed.

33Billing provider info1952529315

33aNPI1952529315

33bProvider type—

28Total paid$304K

24GClaims12,059

24DCodes billed16

24AFirst – last monthJan 2018 – Sep 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	3,255	$62K
2019	2,843	$52K
2020	1,701	$56K
2021	1,858	$69K
2022	2,402	$65K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
96127		33%	1,879	1,664	$101K
G0451	Development testing, with interpretation and report, per standardized instrument form	27%	1,356	1,346	$82K
83655		9.5%	1,543	1,442	$29K
D0190		8.7%	1,641	1,641	$26K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	8.2%	1,630	1,528	$25K
D1206	Topical application of fluoride varnish	7.1%	1,564	1,562	$21K
D1351	Sealant - per tooth	2.4%	158	121	$7K
90460	Immunization administration through 18 years of age via any route, first or only component	1.9%	154	154	$6K
D1330		1.2%	234	234	$4K
D0602		<1%	1,572	1,571	$2K
D0145	Oral evaluation for a patient under three years of age	<1%	27	27	$526.23
36416		<1%	83	82	$206.59

4 more codes

D0603	<1%	88	$82.24
90461	<1%	58	$1.67
90688	<1%	44	$0.19
90734	0%	28	$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.