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NPI 1750445623
NPI deactivated
1750445623
1750445623 was paid $5.33M by Medicaid between Jan 2018 and Apr 2023, across 18 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 — 30% of everything it billed.
33Billing provider info1750445623
33aNPI1750445623
33bProvider type—
28Total paid$5.33M
24GClaims53,744
24DCodes billed18
24AFirst – last monthJan 2018 – Apr 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 | 6,117 | $786K | |
| 2019 | 7,348 | $834K | |
| 2020 | 15,235 | $1.37M | |
| 2021 | 11,928 | $1.06M | |
| 2022 | 10,546 | $995K | |
| 2023 | 2,570 | $284K |
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 | 30% | 4,951 | 3,262 | $1.61M |
| 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 | 16% | 6,795 | 4,238 | $830K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 15% | 14,177 | 8,985 | $820K |
| 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 | 8.5% | 4,244 | 2,710 | $451K |
| 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 | 6.9% | 3,084 | 1,872 | $368K |
| B4100 | Food thickener, administered orally, per ounce | 5.7% | 3,685 | 2,635 | $302K |
| 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 | 5.4% | 1,935 | 845 | $289K |
| 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 | 3.8% | 609 | 322 | $203K |
| B9998 | Noc for enteral supplies | 3.0% | 6,529 | 4,462 | $157K |
| 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 | 2.0% | 3,974 | 2,544 | $105K |
| A4213 | Syringe, sterile, 20 cc or greater, each | 1.4% | 882 | 649 | $77K |
| 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 | 1.3% | 319 | 171 | $71K |
6 more codes
| B9002 | Enteral nutrition infusion pump, any type | <1% | 926 | $19K |
| B4162 | Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | <1% | 81 | $15K |
| A4322 | Irrigation syringe, bulb or piston, each | <1% | 731 | $5K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | <1% | 616 | $2K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | <1% | 166 | $2K |
| E0776 | Iv pole | <1% | 40 | $243.47 |
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.