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NPI 1184653388
NPI deactivated
1184653388
1184653388 was paid $60.09M by Medicaid between Jan 2018 and Dec 2024, across 58 billing codes. Its largest line is 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 — 28% of everything it billed.
33Billing provider info1184653388
33aNPI1184653388
33bProvider type—
28Total paid$60.09M
24GClaims255,422
24DCodes billed58
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 | 27,887 | $6.07M | |
| 2019 | 31,819 | $7.79M | |
| 2020 | 28,726 | $7.06M | |
| 2021 | 40,526 | $9.58M | |
| 2022 | 44,511 | $10.76M | |
| 2023 | 44,301 | $10.13M | |
| 2024incomplete | 37,652 | $8.70M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 28% | 44,077 | 36,249 | $16.64M |
| 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 | 15% | 17,781 | 15,939 | $8.78M |
| 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 | 6.6% | 11,612 | 10,169 | $3.98M |
| 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 | 4.9% | 19,730 | 17,962 | $2.96M |
| J1559 | Injection, immune globulin (hizentra), 100 mg | 4.0% | 3,219 | 1,523 | $2.40M |
| 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 | 3.8% | 8,371 | 7,505 | $2.27M |
| 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 | 3.6% | 5,079 | 4,496 | $2.15M |
| 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 | 3.3% | 16,615 | 14,748 | $1.96M |
| 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 | 2.8% | 15,839 | 14,140 | $1.70M |
| 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 | 2.8% | 8,509 | 2,357 | $1.70M |
| B4185 | Parenteral nutrition solution, not otherwise specified, 10 grams lipids | 2.5% | 7,987 | 2,155 | $1.51M |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 2.5% | 223 | 212 | $1.50M |
46 more codes
| S9366 | Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem | 2.2% | 5,960 | $1.33M |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 1.5% | 11,140 | $873K |
| 99601 | 1.4% | 9,892 | $867K | |
| 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 | 1.4% | 1,182 | $844K |
| S9502 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | 1.4% | 3,418 | $823K |
| 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 | 1.2% | 3,799 | $732K |
| 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 | 1.1% | 6,904 | $665K |
| 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 | 1.0% | 6,833 | $621K |
| B4157 | Enteral formula, nutritionally complete, for 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 | 1.0% | 676 | $603K |
| B4197 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix | <1% | 542 | $540K |
| B4158 | Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit | <1% | 2,265 | $509K |
| S9501 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | <1% | 2,631 | $502K |
| S9373 | Home infusion therapy, hydration therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use with hydration therapy codes s9374-s9377 using daily volume scales) | <1% | 4,445 | $463K |
| 99602 | Nursing care in home rn | <1% | 4,496 | $459K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 9,974 | $402K |
| 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 | <1% | 2,387 | $383K |
| S9341 | Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | <1% | 947 | $367K |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | <1% | 67 | $338K |
| B4103 | Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit | <1% | 1,510 | $163K |
| Q5103 | Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg | <1% | 63 | $160K |
| 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 | <1% | 356 | $137K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 4,021 | $96K |
| B4189 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix | <1% | 128 | $95K |
| B4100 | Food thickener, administered orally, per ounce | <1% | 1,008 | $93K |
| S9367 | Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem | <1% | 432 | $92K |
| S9359 | Home infusion therapy, anti-tumor necrosis factor intravenous therapy; (e.g., infliximab); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | <1% | 819 | $66K |
| J3490 | Unclassified drugs | <1% | 200 | $65K |
| B9002 | Enteral nutrition infusion pump, any type | <1% | 2,916 | $60K |
| B4193 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix | <1% | 58 | $43K |
| S5502 | Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use) | <1% | 1,253 | $40K |
| S9365 | Home infusion therapy, total parenteral nutrition (tpn); one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem | <1% | 80 | $32K |
| S5501 | Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | <1% | 251 | $16K |
| B4036 | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 458 | $16K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | <1% | 2,187 | $13K |
| J1955 | Injection, levocarnitine, per 1 gm | <1% | 121 | $10K |
| B4224 | Parenteral nutrition administration kit, per day | <1% | 441 | $9K |
| A4222 | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) | <1% | 65 | $8K |
| B4087 | Gastrostomy/jejunostomy tube, standard, any material, any type, each | <1% | 549 | $8K |
| B4104 | Additive for enteral formula (e.g., fiber) | <1% | 58 | $5K |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 92 | $3K |
| B4220 | Parenteral nutrition supply kit; premix, per day | <1% | 367 | $3K |
| B4102 | Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit | <1% | 13 | $2K |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 82 | $1K |
| K0552 | Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each | <1% | 1,214 | $1K |
| S0028 | Injection, famotidine, 20 mg | <1% | 41 | $361.52 |
| A4223 | Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) | 0% | 39 | $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.