1396794483

1396794483 was paid $1.39M by Medicaid between Jan 2018 and Aug 2022, across 19 billing codes. Its largest line is S9340, Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem — 42% of everything it billed.

33Billing provider info1396794483

33aNPI1396794483

33bProvider type—

28Total paid$1.39M

24GClaims10,655

24DCodes billed19

24AFirst – last monthJan 2018 – Aug 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	2,426	$208K
2019	2,726	$281K
2020	1,868	$249K
2021	2,549	$431K
2022	1,086	$222K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
S9340	Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem	42%	1,474	1,356	$578K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	17%	2,005	1,783	$230K
A4223	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)	14%	1,865	467	$189K
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	11%	742	567	$154K
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	3.6%	380	319	$50K
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	3.1%	490	469	$43K
J1642	Injection, heparin sodium, (heparin lock flush), per 10 units	2.4%	1,186	322	$33K
B9002	Enteral nutrition infusion pump, any type	2.1%	455	453	$29K
S9500	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem	1.9%	200	52	$27K
B9998	Noc for enteral supplies	1.4%	413	381	$19K
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%	107	96	$10K
A4216	Sterile water, saline and/or dextrose, diluent/flush, 10 ml	<1%	582	280	$8K

7 more codes

B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	<1%	99	$6K
A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	<1%	198	$6K
99601		<1%	33	$3K
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	<1%	22	$2K
A4245	Alcohol wipes, per box	<1%	42	$2K
A4927	Gloves, non-sterile, per 100	<1%	265	$327.98
A4209	Syringe with needle, sterile 5 cc or greater, each	<1%	97	$120.86

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.