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NPI 1396021598
NPI deactivated
1396021598
1396021598 was paid $8.00M by Medicaid between Oct 2020 and Dec 2024, across 24 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 — 25% of everything it billed.
33Billing provider info1396021598
33aNPI1396021598
33bProvider type—
28Total paid$8.00M
24GClaims68,092
24DCodes billed24
24AFirst – last monthOct 2020 – 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 | |
|---|---|---|---|
| 2020 | 32 | $4K | |
| 2021 | 13 | $1K | |
| 2022 | 7,449 | $1.92M | |
| 2023 | 26,940 | $3.38M | |
| 2024incomplete | 33,658 | $2.70M |
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 | 25% | 37,945 | 4,480 | $1.97M |
| 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 | 12% | 1,545 | 1,424 | $923K |
| 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 | 10% | 1,560 | 1,413 | $833K |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | 8.8% | 98 | 76 | $703K |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 7.7% | 164 | 111 | $612K |
| 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 | 4.6% | 3,121 | 2,834 | $369K |
| 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 | 4.6% | 1,941 | 1,786 | $369K |
| 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 | 4.2% | 1,195 | 1,097 | $339K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 4.2% | 4,039 | 3,685 | $336K |
| 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 | 3.9% | 2,668 | 2,438 | $311K |
| 99602 | Nursing care in home rn | 3.6% | 1,681 | 967 | $288K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 3.0% | 1,705 | 1,677 | $239K |
12 more codes
| 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 | 2.3% | 2,738 | $184K |
| 99601 | 2.1% | 1,939 | $168K | |
| 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 | 1.6% | 674 | $129K |
| 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 | 1.2% | 1,422 | $92K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 1.0% | 2,037 | $83K |
| 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% | 598 | $27K |
| B4036 | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 192 | $11K |
| B9002 | Enteral nutrition infusion pump, any type | <1% | 434 | $7K |
| A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | <1% | 252 | $607.15 |
| B4087 | Gastrostomy/jejunostomy tube, standard, any material, any type, each | <1% | 50 | $297.00 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 78 | $241.27 |
| J7050 | Infusion, normal saline solution, 250 cc | <1% | 16 | $30.13 |
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.