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NPI 1881639755
NPI deactivated
1881639755
1881639755 was paid $10.62M by Medicaid between Jan 2018 and Dec 2024, across 22 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 — 22% of everything it billed.
33Billing provider info1881639755
33aNPI1881639755
33bProvider type—
28Total paid$10.62M
24GClaims79,041
24DCodes billed22
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 | 10,505 | $1.17M | |
| 2019 | 13,416 | $1.48M | |
| 2020 | 12,072 | $1.66M | |
| 2021 | 14,049 | $1.73M | |
| 2022 | 10,418 | $1.57M | |
| 2023 | 11,688 | $1.57M | |
| 2024incomplete | 6,893 | $1.44M |
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 | 22% | 3,210 | 2,599 | $2.32M |
| A4223 | Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) | 20% | 20,849 | 3,743 | $2.08M |
| 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 | 18% | 5,141 | 4,133 | $1.86M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 15% | 11,040 | 8,402 | $1.57M |
| 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 | 9.6% | 2,942 | 2,405 | $1.02M |
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 3.6% | 5,435 | 4,344 | $381K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 3.2% | 4,101 | 3,610 | $337K |
| 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 | 3.0% | 3,168 | 2,320 | $321K |
| 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 | 2.2% | 2,677 | 1,955 | $238K |
| B9002 | Enteral nutrition infusion pump, any type | 1.2% | 2,778 | 2,553 | $128K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | <1% | 13,763 | 3,983 | $89K |
| 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% | 179 | 131 | $83K |
10 more codes
| 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% | 571 | $80K |
| E0776 | Iv pole | <1% | 1,142 | $47K |
| 99601 | <1% | 550 | $40K | |
| 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% | 701 | $14K |
| 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% | 234 | $6K |
| 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% | 74 | $5K |
| B9998 | Noc for enteral supplies | <1% | 400 | $3K |
| A4222 | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) | <1% | 18 | $52.33 |
| J0878 | Injection, daptomycin, 1 mg | <1% | 40 | $2.73 |
| B4185 | Parenteral nutrition solution, not otherwise specified, 10 grams lipids | 0% | 28 | $0.00 |
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.