Johnson, Jack

Johnson, Jack was paid $12K by Medicaid between Jul 2019 and Oct 2019, across 6 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 69% of everything it billed.

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
2019	275	$12K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	69%	144	127	$8K
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	21%	31	29	$2K
90461		4.2%	27	27	$494.41
90460	Immunization administration through 18 years of age via any route, first or only component	2.7%	32	32	$322.88
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	2.5%	29	29	$298.99
85018		<1%	12	12	$19.68

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.