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NPI 1720187362
NPI deactivated
1720187362
1720187362 was paid $5.38M by Medicaid between Jan 2018 and Dec 2024, across 25 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 — 18% of everything it billed.
33Billing provider info1720187362
33aNPI1720187362
33bProvider type—
28Total paid$5.38M
24GClaims38,945
24DCodes billed25
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 | 5,162 | $781K | |
| 2019 | 5,879 | $883K | |
| 2020 | 6,806 | $879K | |
| 2021 | 7,197 | $1.07M | |
| 2022 | 5,617 | $654K | |
| 2023 | 4,807 | $617K | |
| 2024incomplete | 3,477 | $495K |
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 | 18% | 1,669 | 1,489 | $950K |
| 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 | 17% | 2,892 | 2,222 | $906K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 15% | 6,460 | 4,880 | $792K |
| B4185 | Parenteral nutrition solution, not otherwise specified, 10 grams lipids | 9.2% | 2,216 | 560 | $495K |
| A4222 | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) | 4.9% | 1,901 | 536 | $261K |
| B4224 | Parenteral nutrition administration kit, per day | 4.5% | 2,139 | 488 | $242K |
| A4223 | Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) | 4.5% | 1,447 | 605 | $241K |
| 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 | 4.0% | 2,006 | 1,687 | $214K |
| 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 | 3.6% | 2,121 | 1,774 | $193K |
| 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 | 3.5% | 1,789 | 1,538 | $190K |
| B4087 | Gastrostomy/jejunostomy tube, standard, any material, any type, each | 2.6% | 1,503 | 1,335 | $139K |
| B9002 | Enteral nutrition infusion pump, any type | 2.3% | 1,870 | 1,751 | $123K |
13 more codes
| B4189 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix | 2.1% | 96 | $114K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 2.0% | 1,748 | $109K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | 1.6% | 4,341 | $85K |
| B4220 | Parenteral nutrition supply kit; premix, per day | 1.4% | 1,986 | $73K |
| E0781 | Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient | 1.2% | 333 | $64K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 1.1% | 992 | $57K |
| S9460 | Diabetic management program, nurse visit | <1% | 367 | $45K |
| 99601 | <1% | 316 | $39K | |
| B4100 | Food thickener, administered orally, per ounce | <1% | 534 | $17K |
| 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% | 19 | $9K |
| 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% | 160 | $7K |
| 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 | <1% | 25 | $5K |
| B9004 | Parenteral nutrition infusion pump, portable | <1% | 15 | $5K |
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.