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NPI 1578505897
NPI deactivated
1578505897
1578505897 was paid $13.26M 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 — 27% of everything it billed.
33Billing provider info1578505897
33aNPI1578505897
33bProvider type—
28Total paid$13.26M
24GClaims72,050
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 | 7,373 | $1.25M | |
| 2019 | 11,808 | $1.66M | |
| 2020 | 12,457 | $1.52M | |
| 2021 | 10,596 | $1.78M | |
| 2022 | 11,191 | $2.22M | |
| 2023 | 9,787 | $2.52M | |
| 2024incomplete | 8,838 | $2.31M |
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 | 27% | 3,866 | 3,333 | $3.59M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 21% | 15,675 | 13,083 | $2.83M |
| 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 | 12% | 5,088 | 4,476 | $1.59M |
| 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 | 8.5% | 2,729 | 2,307 | $1.13M |
| 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 | 7.0% | 1,995 | 1,667 | $926K |
| 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 | 5.3% | 2,774 | 2,311 | $701K |
| 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 | 4.1% | 4,835 | 4,138 | $538K |
| 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 | 3.2% | 3,168 | 2,618 | $425K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 2.7% | 3,777 | 3,586 | $363K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 2.1% | 4,386 | 3,576 | $273K |
| B9002 | Enteral nutrition infusion pump, any type | 1.7% | 4,560 | 4,322 | $224K |
| B4036 | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 1,936 | 1,710 | $118K |
12 more codes
| 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% | 2,256 | $108K |
| A4223 | Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) | <1% | 3,016 | $105K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | <1% | 5,759 | $80K |
| B4224 | Parenteral nutrition administration kit, per day | <1% | 1,596 | $65K |
| 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 | <1% | 958 | $58K |
| B9998 | Noc for enteral supplies | <1% | 486 | $43K |
| 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 | <1% | 296 | $37K |
| A4222 | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) | <1% | 416 | $36K |
| E0781 | Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient | <1% | 1,991 | $11K |
| A4213 | Syringe, sterile, 20 cc or greater, each | <1% | 390 | $4K |
| E0776 | Iv pole | <1% | 43 | $2K |
| B4220 | Parenteral nutrition supply kit; premix, per day | <1% | 54 | $467.50 |
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.