1124073507

1124073507 was paid $176K by Medicaid between Jan 2018 and Jun 2020, across 6 billing codes. Its largest line is 99601, — 50% of everything it billed.

33Billing provider info1124073507

33aNPI1124073507

33bProvider type—

28Total paid$176K

24GClaims2,086

24DCodes billed6

24AFirst – last monthJan 2018 – Jun 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	1,389	$103K
2019	451	$51K
2020	246	$22K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99601		50%	863	261	$88K
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	25%	203	161	$43K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	13%	386	333	$23K
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	6.6%	173	80	$12K
A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	3.0%	322	168	$5K
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	2.9%	139	123	$5K

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.