Home ›
NPI 1457380206
NPI deactivated
1457380206
1457380206 was paid $1.13M by Medicaid between Jan 2018 and Jul 2022, across 19 billing codes. Its largest line is B4035, Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape — 24% of everything it billed.
33Billing provider info1457380206
33aNPI1457380206
33bProvider type—
28Total paid$1.13M
24GClaims8,638
24DCodes billed19
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 | 1,382 | $212K | |
| 2019 | 1,014 | $272K | |
| 2020 | 1,536 | $162K | |
| 2021 | 2,584 | $276K | |
| 2022 | 2,122 | $205K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 24% | 2,205 | 1,975 | $269K |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 23% | 88 | 50 | $255K |
| 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 | 10% | 979 | 884 | $117K |
| 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 | 9.8% | 1,034 | 968 | $111K |
| 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 | 5.1% | 351 | 320 | $57K |
| 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 | 4.3% | 748 | 140 | $49K |
| 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 | 4.1% | 128 | 118 | $47K |
| B9002 | Enteral nutrition infusion pump, any type | 3.8% | 689 | 678 | $43K |
| 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 | 3.2% | 149 | 134 | $36K |
| J1559 | Injection, immune globulin (hizentra), 100 mg | 3.1% | 67 | 24 | $35K |
| 99601 | 2.6% | 481 | 184 | $29K | |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 1.6% | 225 | 224 | $18K |
7 more codes
| 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 | 1.6% | 787 | $18K |
| B4087 | Gastrostomy/jejunostomy tube, standard, any material, any type, each | 1.3% | 309 | $14K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 1.0% | 287 | $11K |
| 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% | 42 | $6K |
| B4185 | Parenteral nutrition solution, not otherwise specified, 10 grams lipids | <1% | 30 | $6K |
| 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% | 14 | $4K |
| 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% | 25 | $2K |
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.