1508107764

1508107764 was paid $360K by Medicaid between Jan 2018 and Sep 2022, across 8 billing codes. Its largest line is A6010, Collagen based wound filler, dry form, sterile, per gram of collagen — 39% of everything it billed.

33Billing provider info1508107764

33aNPI1508107764

33bProvider type—

28Total paid$360K

24GClaims7,046

24DCodes billed8

24AFirst – last monthJan 2018 – Sep 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	721	$42K
2019	949	$48K
2020	1,452	$84K
2021	2,486	$107K
2022	1,438	$79K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
A6010	Collagen based wound filler, dry form, sterile, per gram of collagen	39%	861	683	$142K
A6212	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	35%	1,848	1,550	$124K
A6545	Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each	12%	875	407	$44K
A6021	Collagen dressing, sterile, size 16 sq. in. or less, each	7.8%	225	163	$28K
A6219	Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	2.9%	1,381	1,011	$10K
A6531	Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each	2.0%	340	156	$7K
L1902	Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf	<1%	53	33	$2K
A6216	Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	<1%	1,463	1,069	$1K

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.