1205885175

1205885175 was paid $263.07 by Medicaid between Jan 2018 and May 2018, across 2 billing codes. Its largest line is A4221, Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) — 96% of everything it billed.

33Billing provider info1205885175

33aNPI1205885175

33bProvider type—

28Total paid$263.07

24GClaims154

24DCodes billed2

24AFirst – last monthJan 2018 – May 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	154	$263.07

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	96%	118	94	$253.04
K0552	Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each	3.8%	36	24	$10.03

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.