1053329052

1053329052 was paid $298K by Medicaid between Jan 2018 and Sep 2018, across 32 billing codes. Its largest line is A0428, Ambulance service, basic life support, non-emergency transport, (bls) — 19% of everything it billed.

33Billing provider info1053329052

33aNPI1053329052

33bProvider type—

28Total paid$298K

24GClaims7,547

24DCodes billed32

24AFirst – last monthJan 2018 – Sep 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	7,547	$298K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
A0428	Ambulance service, basic life support, non-emergency transport, (bls)	19%	347	210	$55K
A0429	Emergency ambulance ride, basic life supportAmbulance service, basic life support, emergency transport (bls-emergency)	18%	440	397	$53K
A0427	Emergency ambulance ride, advanced life supportAmbulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	18%	440	409	$53K
E0601	Continuous positive airway pressure (cpap) device	10%	409	382	$31K
A0130	Non-emergency transportation: wheelchair van	8.1%	684	68	$24K
A0425	Ground mileage, per statute mile	5.0%	1,993	1,075	$15K
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	3.4%	154	149	$10K
K0001	Standard wheelchair	2.9%	285	272	$9K
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	2.6%	176	168	$8K
E0143	Walker, folding, wheeled, adjustable or fixed height	2.5%	102	102	$8K
E0562	Humidifier, heated, used with positive airway pressure device	2.4%	444	421	$7K
E0443	Portable oxygen contents, gaseous, 1 month's supply = 1 unit	2.4%	110	110	$7K

20 more codes

K0003	Lightweight wheelchair	2.0%	99	$6K
A0426	Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)	1.9%	30	$6K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	<1%	49	$3K
E0570	Nebulizer, with compressor	<1%	16	$1K
J1642	Injection, heparin sodium, (heparin lock flush), per 10 units	<1%	140	$856.68
A7035	Headgear used with positive airway pressure device	<1%	69	$726.53
J3490	Unclassified drugs	<1%	185	$403.98
A7038	Filter, disposable, used with positive airway pressure device	<1%	59	$270.29
A7037	Tubing used with positive airway pressure device	<1%	69	$221.48
E0156	Seat attachment, walker	<1%	25	$99.89
J7050	Infusion, normal saline solution, 250 cc	<1%	95	$72.81
J1200	Injection, diphenhydramine hcl, up to 50 mg	<1%	30	$17.87
A0380	Bls mileage (per mile)	<1%	362	$10.40
A0999	Unlisted ambulance service	0%	224	$0.00
A0398	Als routine disposable supplies	0%	78	$0.00
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	0%	26	$0.00
A0424	Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)	0%	225	$0.00
T4541	Incontinence product, disposable underpad, large, each	0%	129	$0.00
A0422	Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation	0%	27	$0.00
A7039	Filter, non disposable, used with positive airway pressure device	0%	26	$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.