1558401851

1558401851 was paid $84K by Medicaid between Oct 2018 and Oct 2023, across 15 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 — 30% of everything it billed.

33Billing provider info1558401851

33aNPI1558401851

33bProvider type—

28Total paid$84K

24GClaims1,329

24DCodes billed15

24AFirst – last monthOct 2018 – Oct 2023

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	32	$8K
2019	32	$10K
2023	1,265	$66K

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	30%	89	78	$25K
T2029	Specialized medical equipment, not otherwise specified, waiver	21%	64	59	$18K
A4425	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each	9.6%	192	177	$8K
A4414	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each	9.2%	114	106	$8K
B9002	Enteral nutrition infusion pump, any type	8.9%	71	70	$7K
A4409	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each	4.6%	114	101	$4K
A4362	Skin barrier; solid, 4 x 4 or equivalent; each	4.6%	127	112	$4K
A4385	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each	4.5%	203	187	$4K
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	4.2%	13	12	$4K
A4406	Ostomy skin barrier, pectin-based, paste, per ounce	1.5%	96	89	$1K
A4407	Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each	<1%	13	13	$799.57
A4357	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each	<1%	85	74	$330.71

3 more codes

A4371	Ostomy skin barrier, powder, per oz	<1%	74	$210.08
A5120	Skin barrier, wipes or swabs, each	<1%	46	$189.64
A4367	Ostomy belt, each	<1%	28	$99.28

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.