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NPI 1770509218
NPI deactivated
1770509218
1770509218 was paid $4.47M by Medicaid between Jan 2018 and Aug 2022, across 14 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 — 23% of everything it billed.
33Billing provider info1770509218
33aNPI1770509218
33bProvider type—
28Total paid$4.47M
24GClaims29,843
24DCodes billed14
24AFirst – last monthJan 2018 – Aug 2022
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 | 5,712 | $841K | |
| 2019 | 6,100 | $999K | |
| 2020 | 7,086 | $1.17M | |
| 2021 | 7,055 | $1.01M | |
| 2022 | 3,890 | $446K |
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 | 23% | 2,422 | 1,890 | $1.04M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 22% | 8,844 | 4,516 | $1.00M |
| 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 | 8.0% | 2,276 | 1,782 | $359K |
| 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 | 7.7% | 2,641 | 2,167 | $342K |
| 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 | 6.9% | 502 | 407 | $306K |
| 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 | 6.5% | 781 | 543 | $291K |
| 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 | 5.6% | 1,748 | 1,385 | $252K |
| B9998 | Noc for enteral supplies | 5.1% | 1,932 | 1,472 | $226K |
| 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 | 4.8% | 1,469 | 1,209 | $216K |
| B9002 | Enteral nutrition infusion pump, any type | 3.6% | 3,291 | 1,841 | $162K |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 2.8% | 2,731 | 1,504 | $126K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 2.5% | 1,065 | 962 | $111K |
2 more codes
| 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% | 99 | $29K |
| B4103 | Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit | <1% | 42 | $4K |
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.