1528345519

1528345519 was paid $6.26M by Medicaid between Jan 2018 and Dec 2024, across 24 billing codes. Its largest line is 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 — 20% of everything it billed.

33Billing provider info1528345519

33aNPI1528345519

33bProvider type—

28Total paid$6.26M

24GClaims37,191

24DCodes billed24

24AFirst – last monthJan 2018 – 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
2018	8,377	$1.45M
2019	8,165	$1.46M
2020	6,498	$1.04M
2021	5,514	$1.05M
2022	4,031	$653K
2023	2,937	$418K
2024incomplete	1,669	$188K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	20%	2,198	1,973	$1.24M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	18%	6,344	5,045	$1.12M
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	13%	2,357	1,691	$838K
J1559	Injection, immune globulin (hizentra), 100 mg	9.6%	566	168	$598K
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	9.2%	3,813	3,379	$575K
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	6.4%	2,450	2,114	$398K
B4087	Gastrostomy/jejunostomy tube, standard, any material, any type, each	4.2%	2,843	2,215	$261K
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	4.1%	2,212	1,768	$260K
A4223	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)	4.1%	1,515	677	$259K
A4222	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)	2.9%	1,334	503	$182K
B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	2.1%	1,691	1,500	$129K
A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	1.9%	5,909	2,648	$119K

12 more codes

B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	1.7%	1,742	$108K
B9002	Enteral nutrition infusion pump, any type	1.3%	1,065	$80K
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%	44	$23K
B4224	Parenteral nutrition administration kit, per day	<1%	227	$21K
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%	231	$11K
B4185	Parenteral nutrition solution, not otherwise specified, 10 grams lipids	<1%	46	$10K
B4100	Food thickener, administered orally, per ounce	<1%	262	$8K
99601		<1%	69	$7K
B4220	Parenteral nutrition supply kit; premix, per day	<1%	227	$7K
E0781	Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient	<1%	12	$3K
S9460	Diabetic management program, nurse visit	<1%	21	$3K
S9470	Nutritional counseling, dietitian visit	0%	13	$0.00

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.