1366729451

1366729451 was paid $3.59M by Medicaid between Jan 2018 and Jul 2022, across 20 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 — 17% of everything it billed.

33Billing provider info1366729451

33aNPI1366729451

33bProvider type—

28Total paid$3.59M

24GClaims29,502

24DCodes billed20

24AFirst – last monthJan 2018 – Jul 2022

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	6,908	$817K
2019	6,897	$746K
2020	6,922	$866K
2021	5,727	$766K
2022	3,048	$396K

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	17%	1,181	842	$623K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	16%	4,498	3,709	$571K
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	13%	4,303	2,875	$479K
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	9.7%	1,995	1,552	$348K
A4223	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)	8.0%	2,864	1,122	$288K
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	7.7%	1,670	1,150	$275K
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	7.5%	543	414	$271K
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	6.6%	2,372	1,943	$237K
B9998	Noc for enteral supplies	3.1%	1,501	1,334	$113K
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	2.6%	996	941	$92K
B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	2.5%	1,356	1,176	$90K
B9002	Enteral nutrition infusion pump, any type	2.0%	1,339	1,249	$72K

8 more codes

A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	1.5%	3,767	$54K
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	<1%	114	$36K
99601		<1%	214	$19K
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%	424	$17K
B4224	Parenteral nutrition administration kit, per day	<1%	149	$4K
B4220	Parenteral nutrition supply kit; premix, per day	<1%	149	$1K
A4305	Disposable drug delivery system, flow rate of 50 ml or greater per hour	<1%	44	$980.21
A4209	Syringe with needle, sterile 5 cc or greater, each	<1%	23	$21.88

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.