1700104205

1700104205 was paid $6K by Medicaid between Mar 2018 and Jul 2018, across 8 billing codes. Its largest line is A5063, Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each — 24% of everything it billed.

33Billing provider info1700104205

33aNPI1700104205

33bProvider type—

28Total paid$6K

24GClaims280

24DCodes billed8

24AFirst – last monthMar 2018 – Jul 2018

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	280	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
A5063	Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each	24%	31	27	$1K
A4414	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each	23%	33	25	$1K
A4409	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each	16%	12	12	$995.08
A4357	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each	16%	81	64	$939.98
A4314	Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)	11%	16	12	$644.36
A5120	Skin barrier, wipes or swabs, each	7.6%	77	59	$462.60
A4406	Ostomy skin barrier, pectin-based, paste, per ounce	2.1%	16	13	$130.31
A4452	Tape, waterproof, per 18 square inches	1.2%	14	12	$69.95

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.