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NPI 1003826694
NPI deactivated
1003826694
1003826694 was paid $6.48M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is B4161, Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit — 14% of everything it billed.
33Billing provider info1003826694
33aNPI1003826694
33bProvider type—
28Total paid$6.48M
24GClaims44,777
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
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 | 4,554 | $573K | |
| 2019 | 5,217 | $717K | |
| 2020 | 6,265 | $1.01M | |
| 2021 | 7,564 | $1.13M | |
| 2022 | 7,395 | $976K | |
| 2023 | 8,585 | $1.16M | |
| 2024incomplete | 5,197 | $915K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| B4161 | Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 14% | 950 | 745 | $876K |
| S9342 | Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | 12% | 1,644 | 1,288 | $799K |
| B4152 | Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 12% | 5,179 | 3,708 | $790K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 9.8% | 5,249 | 3,384 | $638K |
| B4150 | Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 8.9% | 4,279 | 3,035 | $575K |
| B4153 | Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 8.0% | 669 | 495 | $515K |
| B4160 | Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 3.6% | 1,147 | 955 | $231K |
| 99601 | 3.6% | 3,929 | 1,666 | $230K | |
| S9379 | Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | 3.5% | 2,024 | 525 | $229K |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 3.3% | 416 | 257 | $213K |
| S9500 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | 2.6% | 1,353 | 200 | $171K |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | 2.6% | 2,501 | 1,128 | $166K |
16 more codes
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 2.5% | 3,312 | $160K |
| S9374 | Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | 2.3% | 1,345 | $148K |
| B4185 | Parenteral nutrition solution, not otherwise specified, 10 grams lipids | 2.0% | 990 | $132K |
| B9002 | Enteral nutrition infusion pump, any type | 2.0% | 2,350 | $127K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 1.7% | 1,512 | $111K |
| B4036 | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 1.3% | 1,227 | $83K |
| 99602 | Nursing care in home rn | 1.2% | 1,082 | $79K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | <1% | 1,001 | $51K |
| B9998 | Noc for enteral supplies | <1% | 1,108 | $50K |
| S9343 | Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | <1% | 124 | $49K |
| B4154 | Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | <1% | 87 | $19K |
| A4222 | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) | <1% | 183 | $15K |
| B4155 | Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit | <1% | 187 | $11K |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 718 | $9K |
| A4223 | Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) | <1% | 189 | $2K |
| J1642 | Injection, heparin sodium, (heparin lock flush), per 10 units | <1% | 22 | $20.33 |
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.