1407985922

1407985922 was paid $1.17M by Medicaid between Jan 2018 and May 2019, across 31 billing codes. Its largest line is E0465, Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) — 22% of everything it billed.

33Billing provider info1407985922

33aNPI1407985922

33bProvider type—

28Total paid$1.17M

24GClaims12,081

24DCodes billed31

24AFirst – last monthJan 2018 – May 2019

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	11,270	$1.11M
2019	811	$68K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	22%	391	217	$264K
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	14%	2,620	1,471	$160K
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%	329	299	$146K
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	12%	1,057	931	$136K
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	9.8%	1,151	1,001	$115K
E0445	Oximeter device for measuring blood oxygen levels non-invasively	9.3%	1,079	604	$109K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	8.2%	707	372	$97K
A4483	Moisture exchanger, disposable, for use with invasive mechanical ventilation	3.1%	107	106	$36K
A4624	Tracheal suction catheter, any type other than closed system, each	3.1%	165	146	$36K
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	1.4%	1,567	910	$17K
A4217	Sterile water/saline, 500 ml	1.4%	316	247	$16K
A7520	Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each	<1%	252	145	$10K

19 more codes

A7526	Tracheostomy tube collar/holder, each	<1%	224	$7K
J7626	Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg	<1%	40	$3K
A4629	Tracheostomy care kit for established tracheostomy	<1%	28	$3K
A7000	Canister, disposable, used with suction pump, each	<1%	232	$2K
E0601	Continuous positive airway pressure (cpap) device	<1%	100	$2K
J7606	Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms	<1%	15	$2K
A4628	Oral and/or oropharyngeal suction catheter, each	<1%	185	$2K
J7605	Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms	<1%	21	$2K
Q0513	Pharmacy dispensing fee for inhalation drug(s); per 30 days	<1%	97	$2K
E0570	Nebulizer, with compressor	<1%	171	$2K
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	<1%	16	$1K
E0562	Humidifier, heated, used with positive airway pressure device	<1%	161	$1K
A7002	Tubing, used with suction pump, each	<1%	228	$1K
J7620	Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	<1%	133	$542.70
A7007	Large volume nebulizer, disposable, unfilled, used with aerosol compressor	<1%	163	$522.90
A7003	Administration set, with small volume nonfiltered pneumatic nebulizer, disposable	<1%	294	$444.76
J7613	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	<1%	52	$225.64
A7525	Tracheostomy mask, each	<1%	136	$114.57
A7038	Filter, disposable, used with positive airway pressure device	<1%	44	$95.15

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.