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NPI 1962682690
NPI deactivated
1962682690
1962682690 was paid $57K by Medicaid between Jan 2018 and Mar 2020, across 2 billing codes. Its largest line is X4303, — 95% of everything it billed.
33Billing provider info1962682690
33aNPI1962682690
33bProvider type—
28Total paid$57K
24GClaims1,678
24DCodes billed2
24AFirst – last monthJan 2018 – Mar 2020
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 | 787 | $27K | |
| 2019 | 753 | $25K | |
| 2020 | 138 | $5K |
Box 24 · Service lines
What it billed for
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.