NPI: 1003842477 · DAVENPORT, IA 52807 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 136 | $3K |
| 2020 | 137 | $3K |
| 2021 | 1,461 | $31K |
| 2022 | 425 | $10K |
| 2023 | 352 | $13K |
| 2024 | 246 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose/reagent strips | 1,062 | 1,003 | $21K |
| 0002A | 291 | 290 | $11K | |
| 0001A | 321 | 321 | $10K | |
| A4239 | Non-adju cgm supply allow | 63 | 56 | $6K |
| K1034 | Covid test self-admn/collect | 68 | 68 | $4K |
| 0004A | 105 | 105 | $4K | |
| 0124A | 51 | 51 | $2K | |
| 91320 | 14 | 14 | $1K | |
| 0064A | 31 | 31 | $1K | |
| A4215 | Sterile needle | 69 | 67 | $1K |
| 90686 | 60 | 60 | $979.95 | |
| 90480 | 19 | 19 | $600.00 | |
| 90471 | 60 | 60 | $290.13 | |
| 91300 | 455 | 420 | $0.00 | |
| 91312 | 47 | 47 | $0.00 | |
| 91301 | 41 | 41 | $0.00 |