Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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1912953431

1912953431 was paid $12.51M by Medicaid between Jan 2018 and Dec 2024, across 26 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 — 31% of everything it billed.

33Billing provider info1912953431
33aNPI1912953431
33bProvider type—
28Total paid$12.51M
24GClaims78,164
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2024
Box 24A · Dates of service

Paid by month

$0$100K$200K$300K2018201920202021202220232024
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
YearClaimsPaid
20185,827$822K
20197,839$1.19M
20209,423$1.36M
202110,741$1.62M
202213,237$2.12M
202315,095$2.55M
2024incomplete16,002$2.84M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 31% 8,696 7,835 $3.91M
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 20% 19,916 18,273 $2.48M
B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape 13% 11,012 9,698 $1.60M
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 9.2% 3,556 3,226 $1.15M
B4185 Parenteral nutrition solution, not otherwise specified, 10 grams lipids 3.9% 2,760 439 $489K
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 3.8% 3,276 2,776 $471K
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 3.5% 4,054 3,564 $434K
A4223 Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) 2.8% 1,376 470 $356K
B9002 Enteral nutrition infusion pump, any type 2.3% 4,354 4,097 $288K
B4224 Parenteral nutrition administration kit, per day 2.0% 1,976 463 $253K
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 1.6% 1,190 1,094 $205K
B4088 Gastrostomy/jejunostomy tube, low-profile, any material, any type, each 1.2% 3,213 3,081 $149K
14 more codes
B4034 Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape 1.2% 2,257 $147K
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% 298 $106K
B9998 Noc for enteral supplies <1% 1,922 $84K
A4221 Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) <1% 3,279 $73K
B4220 Parenteral nutrition supply kit; premix, per day <1% 1,908 $72K
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% 435 $64K
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% 773 $42K
B4103 Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit <1% 429 $38K
B4036 Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape <1% 303 $31K
A4211 Supplies for self-administered injections <1% 98 $31K
B4100 Food thickener, administered orally, per ounce <1% 702 $18K
E0776 Iv pole <1% 196 $16K
B4082 Nasogastric tubing without stylet <1% 112 $1K
S9342 Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem 0% 73 $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.