1962863324

1962863324 was paid $148K by Medicaid between Jan 2018 and Jun 2018, across 16 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 34% of everything it billed.

33Billing provider info1962863324

33aNPI1962863324

33bProvider type—

28Total paid$148K

24GClaims1,690

24DCodes billed16

24AFirst – last monthJan 2018 – Jun 2018

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	1,690	$148K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	34%	267	182	$50K
520		27%	180	162	$40K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	26%	376	276	$38K
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	6.1%	103	85	$9K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	2.9%	18	18	$4K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	1.9%	14	14	$3K
G0467	Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	<1%	43	39	$1K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	101	96	$820.97
90472	Immunization administration, each additional vaccine (list separately)	<1%	44	42	$728.03
36415	Collection of venous blood by venipuncture	<1%	187	157	$471.52
81003		<1%	203	137	$235.76
99173		0%	12	12	$0.00

4 more codes

90670	0%	14	$0.00
36416	0%	39	$0.00
85018	0%	77	$0.00
90686	0%	12	$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.