NPI: 1073868063 · BENTON, AR 72015 · 333600000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $112.98 |
| 2019 | 13 | $0.00 |
| 2020 | 14 | $139.05 |
| 2021 | 978 | $17K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0002A | 97 | 94 | $6K | |
| 0001A | 134 | 122 | $6K | |
| 0011A | 172 | 166 | $2K | |
| 0012A | 145 | 145 | $2K | |
| 0071A | 12 | 12 | $1K | |
| 0031A | 12 | 12 | $200.00 | |
| G0008 | Admin influenza virus vac | 14 | 12 | $139.05 |
| 90686 | 12 | 12 | $112.98 | |
| 91300 | 198 | 168 | $1.67 | |
| 91301 | 119 | 108 | $0.98 | |
| 0004A | 49 | 46 | $0.00 | |
| 0013A | 40 | 39 | $0.00 | |
| 90674 | 13 | 13 | $0.00 |