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NPI 1053340893
NPI deactivated
1053340893
1053340893 was paid $5.80M by Medicaid between Jan 2018 and Dec 2024, across 23 billing codes. Its largest line is B4035, Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape — 21% of everything it billed.
33Billing provider info1053340893
33aNPI1053340893
33bProvider type—
28Total paid$5.80M
24GClaims39,564
24DCodes billed23
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 | 3,017 | $325K | |
| 2019 | 2,941 | $332K | |
| 2020 | 5,042 | $653K | |
| 2021 | 7,633 | $927K | |
| 2022 | 7,278 | $1.14M | |
| 2023 | 7,473 | $1.30M | |
| 2024incomplete | 6,180 | $1.13M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 21% | 8,671 | 7,757 | $1.19M |
| 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 | 20% | 2,356 | 2,118 | $1.17M |
| 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 | 9.0% | 4,498 | 4,121 | $523K |
| 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 | 9.0% | 1,386 | 1,276 | $522K |
| 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 | 8.2% | 4,062 | 3,627 | $473K |
| 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 | 7.9% | 1,505 | 1,391 | $455K |
| 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 | 6.8% | 2,627 | 2,397 | $395K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 3.2% | 2,263 | 2,220 | $188K |
| B9002 | Enteral nutrition infusion pump, any type | 2.7% | 3,002 | 2,935 | $156K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 2.2% | 2,719 | 2,471 | $129K |
| 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 | 2.1% | 1,913 | 352 | $123K |
| B4162 | Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 2.0% | 137 | 122 | $116K |
11 more codes
| 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 | 1.3% | 388 | $74K |
| 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 | 1.1% | 1,135 | $66K |
| B4087 | Gastrostomy/jejunostomy tube, standard, any material, any type, each | <1% | 1,136 | $50K |
| B4100 | Food thickener, administered orally, per ounce | <1% | 265 | $44K |
| B4185 | Parenteral nutrition solution, not otherwise specified, 10 grams lipids | <1% | 222 | $41K |
| B4036 | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 306 | $31K |
| 99601 | <1% | 561 | $31K | |
| B9998 | Noc for enteral supplies | <1% | 153 | $16K |
| S9338 | Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | <1% | 64 | $1K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | <1% | 176 | $1K |
| 99602 | Nursing care in home rn | <1% | 19 | $1K |
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.