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NPI 1306961792
NPI deactivated
1306961792
1306961792 was paid $36.08M by Medicaid between Jan 2018 and Aug 2024, across 116 billing codes. Its largest line is 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 — 23% of everything it billed.
33Billing provider info1306961792
33aNPI1306961792
33bProvider type—
28Total paid$36.08M
24GClaims581,902
24DCodes billed116
24AFirst – last monthJan 2018 – Aug 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 | 107,674 | $5.92M | |
| 2019 | 134,251 | $7.29M | |
| 2020 | 120,460 | $8.23M | |
| 2021 | 114,618 | $8.23M | |
| 2022 | 77,293 | $4.60M | |
| 2023 | 27,293 | $1.82M | |
| 2024incomplete | 313 | $525.23 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 23% | 21,125 | 15,324 | $8.41M |
| 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 | 16% | 34,294 | 28,479 | $5.63M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 8.7% | 27,195 | 22,249 | $3.13M |
| B9998 | Noc for enteral supplies | 7.2% | 52,681 | 25,544 | $2.61M |
| 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 | 3.9% | 6,678 | 5,396 | $1.42M |
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 3.3% | 2,721 | 1,691 | $1.18M |
| E0570 | Nebulizer, with compressor | 2.2% | 12,360 | 11,252 | $787K |
| S8189 | Tracheostomy supply, not otherwise classified | 2.2% | 7,456 | 3,349 | $781K |
| 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 | 2.1% | 4,910 | 4,027 | $751K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 2.0% | 16,284 | 13,094 | $721K |
| A4606 | Oxygen probe for use with oximeter device, replacement | 1.8% | 8,610 | 6,644 | $638K |
| E0445 | Oximeter device for measuring blood oxygen levels non-invasively | 1.4% | 6,222 | 4,981 | $497K |
104 more codes
| B9002 | Enteral nutrition infusion pump, any type | 1.4% | 12,137 | $488K |
| B4102 | Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit | 1.3% | 2,286 | $487K |
| A4217 | Sterile water/saline, 500 ml | 1.2% | 7,190 | $425K |
| A4624 | Tracheal suction catheter, any type other than closed system, each | 1.1% | 3,557 | $408K |
| A6197 | Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing | 1.1% | 6,313 | $385K |
| E1399 | Durable medical equipment, miscellaneous | 1.1% | 29,869 | $380K |
| A7526 | Tracheostomy tube collar/holder, each | <1% | 5,106 | $320K |
| 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 | <1% | 3,180 | $306K |
| A4483 | Moisture exchanger, disposable, for use with invasive mechanical ventilation | <1% | 2,442 | $286K |
| A4605 | Tracheal suction catheter, closed system, each | <1% | 1,252 | $283K |
| A4452 | Tape, waterproof, per 18 square inches | <1% | 18,409 | $275K |
| 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 | <1% | 2,608 | $270K |
| E0619 | Apnea monitor, with recording feature | <1% | 2,249 | $269K |
| A7507 | Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each | <1% | 2,389 | $259K |
| A7520 | Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each | <1% | 2,713 | $241K |
| B4103 | Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit | <1% | 2,348 | $236K |
| E0482 | Cough stimulating device, alternating positive and negative airway pressure | <1% | 1,115 | $227K |
| 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 | <1% | 680 | $214K |
| A6402 | Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 19,367 | $202K |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | <1% | 15,808 | $163K |
| A6209 | Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 4,718 | $158K |
| E0603 | Breast pump, electric (ac and/or dc), any type | <1% | 1,223 | $154K |
| 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% | 4,034 | $133K |
| E0443 | Portable oxygen contents, gaseous, 1 month's supply = 1 unit | <1% | 4,147 | $131K |
| A6260 | Wound cleansers, any type, any size | <1% | 5,353 | $125K |
| B4100 | Food thickener, administered orally, per ounce | <1% | 2,299 | $113K |
| A7000 | Canister, disposable, used with suction pump, each | <1% | 8,323 | $108K |
| E0600 | Respiratory suction pump, home model, portable or stationary, electric | <1% | 4,574 | $108K |
| A4927 | Gloves, non-sterile, per 100 | <1% | 8,800 | $107K |
| A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable | <1% | 10,213 | $105K |
| E0202 | Phototherapy (bilirubin) light with photometer | <1% | 1,145 | $104K |
| E1150 | Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests | <1% | 2,056 | $103K |
| B4082 | Nasogastric tubing without stylet | <1% | 2,769 | $102K |
| 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% | 565 | $97K |
| A4625 | Tracheostomy care kit for new tracheostomy | <1% | 990 | $97K |
| A7002 | Tubing, used with suction pump, each | <1% | 8,515 | $96K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | <1% | 4,929 | $92K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 2,291 | $90K |
| A4627 | Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler | <1% | 5,782 | $86K |
| E0776 | Iv pole | <1% | 11,325 | $82K |
| A6210 | Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing | <1% | 468 | $75K |
| A4618 | Breathing circuits | <1% | 3,656 | $75K |
| A4628 | Oral and/or oropharyngeal suction catheter, each | <1% | 5,943 | $70K |
| E1405 | Oxygen and water vapor enriching system with heated delivery | <1% | 2,168 | $69K |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | <1% | 3,050 | $68K |
| A4210 | Needle-free injection device, each | <1% | 18,221 | $66K |
| A4213 | Syringe, sterile, 20 cc or greater, each | <1% | 20,271 | $64K |
| B4036 | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 941 | $61K |
| E0601 | Continuous positive airway pressure (cpap) device | <1% | 1,372 | $54K |
| A6250 | Skin sealants, protectants, moisturizers, ointments, any type, any size | <1% | 5,212 | $51K |
| A4402 | Lubricant, per ounce | <1% | 8,059 | $43K |
| E0424 | Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing | <1% | 1,021 | $42K |
| A4456 | Adhesive remover, wipes, any type, each | <1% | 6,732 | $40K |
| A6234 | Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 1,533 | $35K |
| A6266 | Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard | <1% | 3,391 | $25K |
| A4371 | Ostomy skin barrier, powder, per oz | <1% | 4,008 | $25K |
| E1392 | Portable oxygen concentrator, rental | <1% | 993 | $24K |
| A6258 | Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing | <1% | 1,177 | $23K |
| A7014 | Filter, nondisposable, used with aerosol compressor or ultrasonic generator | <1% | 9,669 | $22K |
| E1060 | Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests | <1% | 221 | $21K |
| A7521 | Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each | <1% | 200 | $20K |
| E0562 | Humidifier, heated, used with positive airway pressure device | <1% | 2,025 | $19K |
| A5200 | Percutaneous catheter/tube anchoring device, adhesive skin attachment | <1% | 754 | $17K |
| L8501 | Tracheostomy speaking valve | <1% | 177 | $16K |
| A6222 | Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 585 | $15K |
| A4351 | Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each | <1% | 87 | $15K |
| A4245 | Alcohol wipes, per box | <1% | 3,845 | $13K |
| E0585 | Nebulizer, with compressor and heater | <1% | 903 | $12K |
| A6216 | Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 1,213 | $11K |
| A7015 | Aerosol mask, used with dme nebulizer | <1% | 11,081 | $10K |
| B4087 | Gastrostomy/jejunostomy tube, standard, any material, any type, each | <1% | 429 | $10K |
| A7525 | Tracheostomy mask, each | <1% | 2,153 | $9K |
| A7046 | Water chamber for humidifier, used with positive airway pressure device, replacement, each | <1% | 643 | $8K |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable | <1% | 3,105 | $7K |
| A7006 | Administration set, with small volume filtered pneumatic nebulizer | <1% | 1,561 | $7K |
| A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | <1% | 205 | $6K |
| A6196 | Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing | <1% | 43 | $6K |
| A4450 | Tape, non-waterproof, per 18 square inches | <1% | 3,238 | $5K |
| A4649 | Surgical supply; miscellaneous | <1% | 1,432 | $4K |
| E0990 | Wheelchair accessory, elevating leg rest, complete assembly, each | <1% | 1,274 | $4K |
| E0974 | Manual wheelchair accessory, anti-rollback device, each | <1% | 1,039 | $3K |
| A7018 | Water, distilled, used with large volume nebulizer, 1000 ml | <1% | 947 | $3K |
| E0471 | Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) | <1% | 29 | $3K |
| A4556 | Electrodes, (e.g., apnea monitor), per pair | <1% | 65 | $3K |
| A4333 | Urinary catheter anchoring device, adhesive skin attachment, each | <1% | 296 | $3K |
| A4244 | Alcohol or peroxide, per pint | <1% | 2,024 | $3K |
| A6257 | Transparent film, sterile, 16 sq. in. or less, each dressing | <1% | 385 | $3K |
| A7020 | Interface for cough stimulating device, includes all components, replacement only | <1% | 222 | $3K |
| A6403 | Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing | <1% | 63 | $2K |
| T4541 | Incontinence product, disposable underpad, large, each | <1% | 152 | $2K |
| A7037 | Tubing used with positive airway pressure device | <1% | 278 | $2K |
| A4616 | Tubing (oxygen), per foot | <1% | 1,738 | $2K |
| A4322 | Irrigation syringe, bulb or piston, each | <1% | 119 | $1K |
| E0978 | Wheelchair accessory, positioning belt/safety belt/pelvic strap, each | <1% | 1,306 | $1K |
| A7038 | Filter, disposable, used with positive airway pressure device | <1% | 975 | $1K |
| A4615 | Cannula, nasal | <1% | 1,756 | $1K |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 506 | $1K |
| A7039 | Filter, non disposable, used with positive airway pressure device | <1% | 460 | $1K |
| A7008 | Large volume nebulizer, disposable, prefilled, used with aerosol compressor | <1% | 60 | $1K |
| A7035 | Headgear used with positive airway pressure device | <1% | 58 | $442.39 |
| A4557 | Lead wires, (e.g., apnea monitor), per pair | <1% | 17 | $208.41 |
| E1355 | Stand/rack | <1% | 48 | $86.18 |
| A9270 | Non-covered item or service | <1% | 664 | $43.70 |
| A7013 | Filter, disposable, used with aerosol compressor or ultrasonic generator | <1% | 31 | $13.41 |
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.