1215930110

1215930110 was paid $528K by Medicaid between Jan 2018 and Aug 2021, across 17 billing codes. Its largest line is E1390, Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate — 33% of everything it billed.

33Billing provider info1215930110

33aNPI1215930110

33bProvider type—

28Total paid$528K

24GClaims11,911

24DCodes billed17

24AFirst – last monthJan 2018 – Aug 2021

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	3,298	$164K
2019	2,530	$132K
2020	3,762	$158K
2021	2,321	$74K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	33%	2,871	2,595	$175K
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	27%	1,300	1,192	$142K
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	8.9%	1,992	1,827	$47K
E0601	Continuous positive airway pressure (cpap) device	7.4%	789	712	$39K
E0562	Humidifier, heated, used with positive airway pressure device	5.7%	790	726	$30K
E0570	Nebulizer, with compressor	5.2%	1,452	1,390	$28K
E0260	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	3.1%	549	485	$16K
A4554	Disposable underpads, all sizes	2.9%	511	491	$15K
K0001	Standard wheelchair	1.5%	602	548	$8K
A7037	Tubing used with positive airway pressure device	1.2%	313	281	$6K
A7030	Full face mask used with positive airway pressure device, each	1.2%	91	74	$6K
A7005	Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable	1.1%	213	205	$6K

5 more codes

A7035	Headgear used with positive airway pressure device	<1%	157	$4K
A7039	Filter, non disposable, used with positive airway pressure device	<1%	154	$3K
A7031	Face mask interface, replacement for full face mask, each	<1%	91	$3K
E0114	Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips	<1%	24	$828.75
L3908	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	<1%	12	$593.08

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.